The promoter of the
monoamine oxidase A (
MAO-A) gene was analysed to test whether length variation of the repeat polymorphism contributes to variation in individual vulnerability to aggressive-criminal behaviour, and liability to
heroin dependence. The repeat number of the
MAO-A polymorphism was assessed in 199 male subjects of Italian descent, a sample comprising 95 healthy subjects and 104
heroin-dependent subjects including 52 addicted individuals with violent behaviour and
antisocial personality disorder. The frequency of the low-activity 3-repeat allele was significantly higher in violent offenders among
heroin addicts, compared to addicted individuals without antisocial behaviour (34.6 vs. 15.4%; p<0.03) and controls (18.9%; p<0.05). No significant difference was evidenced in the frequencies of the
MAO-A alleles between
heroin-dependent subjects in general and control subjects. High activity 4-repeat allele frequency was significantly higher in addicted individuals without
antisocial behavior compared to antisocial-aggressive
heroin-dependent subjects (76.9 vs. 55.8%; p<0.02). Buss Durkee Hostility Inventory (BDHI) mean total scores were significantly higher in
heroin addicts than in controls (p<0.001), and in antisocial-violent
heroin addicts in comparison with addicted individuals without antisocial behaviour (p<0.005). Among
heroin addicts BDHI irritability, suspiciousness and resentment subscales scores were found significantly higher in low activity 3-repeat allele subjects than in high activity alleles subjects (p<0.001; p<0.05; p<0.05, respectively). No association was found between
MAO-A polymorphism and suicide history. Our findings suggest that the low-activity 3-repeat allele of the
MAO-A promoter polymorphism confers increased susceptibility to antisocial-violent behavior and aggressiveness, rather than
drug dependence per se, in
heroin-dependent males.