We previously reported that 21 individuals with APD were found to have a reduction in prefrontal gray matter volumes compared with normal controls, psychiatric controls, and substance/alcohol–dependent controls.1 As Seifritz et al point out, the APD group had significantly higher rates of cocaine dependence than the substance-dependent control group (66.7% vs 30.8%). This appropriately raises the question as to whether the volume reduction in prefrontal gray matter is due to cocaine dependence.
Raine A. Is Prefrontal Cortex Thinning Specific for Antisocial Personality Disorder?—Reply. Arch Gen Psychiatry. 2001;58(4):402-403. doi: