Before the 1960s, personality disorders were viewed as unreliable diagnoses of limited clinical utility. 1 The prevalence of any personality disorder was 9.1% and borderline personality disorder was 1.4%. Accordingly, the primary aim of this study was to assess the prevalence rates of personality disorders in the general adult population in Western countries. Of those that were reviewed in full text, 42 were excluded. Khalifa, Najat R See Fig. Based on the classification provided by Rotenstein et al,Reference Rotenstein, Ramos, Torre, Segal, Peluso and Guille20 individual criteria are summed to generate a total score that can range from 0 to 5, and studies can be judged to be of low risk of bias (3 points) or high risk of bias (<3 points). Teodor, Mihai Vllm, Birgit A WebResults: The estimated overall prevalence of DSM-IV personality disorders was 9%. Spanemberg, Lucas The complete reference citations are provided in Supplementary Table 1. Lower scores indicate a higher chance of bias in prevalence estimates (e.g. We found that heterogeneity, although slightly reduced, remained high across all subgroup analyses. A random-effects model was chosen as this model addresses heterogeneity between studies and study populations, and is more robust in case of large variations in sample size.Reference Cooper, Hedges and Valentine22 The magnitude of heterogeneity was assessed by the I 2 index.Reference Lipsey and Wilson23 Reported confidence intervals reflect a 95% criterion. We combined prevalence figures from individual studies quantitatively, using meta-analysis. We added two further criteria to this scale: (dii) ascertainment of personality diagnosis by self-rating versus expert rating and (f) ascertainment of prevalence estimate. Personality Disorders How should meta-regression analyses be undertaken and interpreted? The final sample comprised ten studies, with a total of 113 998 individuals. Mental Disorders: Personality Disorders - PubMed Cluster A personality disorders were relatively common in high-income countries (4.2%) and LMICs (3.4%). The global pooled prevalence of any personality disorder was 7.8% (95% CI 6.19.5). Five studies assessed lifetime prevalence rates of personality disorders (studies 1, 2, 4, 7 and 10), two studies assessed a 5- to 10-year time period (studies 6 and 8) and three studies assessed a 5-year time period (studies 3, 5 and 9). assessment tool used in just one study, e.g. Furthermore, variations may be associated with limitations of a transcultural diagnostic assessment of personality disorders, as this study was conducted in Turkey, which could be regarded as a non-Western country. McCarthy, Lucy Vicari, Stefano 12 July 2019. (2) What is the prevalence of cluster A, B and C personality disorders in the community? More large-scale studies with standardised methodologies are now needed to increase our understanding of population needs and regional variations. Asia (China) cluster A (3.1%) cluster B (1.3%) cluster C (1.4%) Africa. Kaliush, Parisa R. Tyler, Nichola This makes things difficult. For the quality assessment of the studies, we used an adapted version of the NewcastleOttawa Scale (NOS).Reference Wells, Shea, O'Connell, Peterson, Welch and Losos19 The original NOS comprised the following criteria: (a) sample representativeness, (b) sample size, (c) non-respondents, (di) ascertainment of personality disorder diagnosis by common measures and (e) quality of descriptive statistics reporting. Edlund, Mark J. However, these results should be interpreted with caution because the number of included studies was too low to properly assess the funnel plot or use more advanced regression-based assessments. Of the original 3876 abstracts, 535 articles were selected for full-text review. and Epidemiological research on personality disorders is relatively sparse, with a paucity of data from lower-income countries from which to draw comparative conclusions. The structure of personality pathology: both general (g) and specific (s) factors? Mental Disorders: Personality Disorders Despite the significant individual and societal burden associated with personality disorders, the epidemiology appears insufficiently described. b. Three studies (eight estimates) reported prevalence rates in LMICs (pooled prevalence 1.5%, 95% CI 0.92.1%, I 2=93.2%, Q=103.3, d.f. personality disorders were assessed during one wave of the study)Reference Polanczyk, Salum, Sugaya, Caye and Rohde14 and reported a prevalence figure for any personality disorder or a cluster A, B or C personality disorder. 3), with income status of country accounting for 18.7% of between-study variance. In a nationwide household study, Jackson and BurgessReference Jackson and Burgess77 reported a more conservative prevalence of 6.6% when using the IPDE. and Total loading time: 0 2021. Nigeria. 2019. The first thing to note is most of the Cluster B types are not going to present Ttofi, Maria M. due to lack of sample representativeness or measurement reliability).Reference Munn, Moola, Riitano and Lisy25 Studies ranged in scores between 2 and 7.5, with a mean score of 5.1. Subgroup analysis and univariate meta-regression results for the diagnosis of any personality disorder. and =7, P<0.001) and 11 (12 estimates) in high-income countries (pooled prevalence 4.2%, 95% CI 3.35.0%, I 2=94.2%, Q=173.4, d.f. Epidemiological studies on personality disorders in community samples are rare, whereas prevalence rates are fairly high and vary substantially depending on samples and methods. gender and ethnicity of sample) as there were insufficient data. Prevalence of personality disorders in the general adult WebBased on diagnostic interview data from the National Comorbidity Study Replication (NCS-R), Figure 1 shows the past year prevalence of U.S. adults aged 18 and older with personality Prevalence and A.B. Personality Disorders prevalence For personality disorder not otherwise specified, the estimate was 1.6% with only one included study (Table 2). Fig. Grenyer, Brin F. S. d. Clinical reappraisal interview sample. Simonsen, Erik Interrater reliability was acceptable (kappa 0.82). Cheung, Natalie H-Y Second, the number of included studies is low, which may have influenced confidence intervals and limit the generalisability of findings. all one-step studies were from high-income countries, potentially inflating the gap between high-income countries and LMICs). Assessment in this study was conducted with the Jamaica Personality Disorder Inventory (JPDI), which identifies a cut point of ten or more as indicative of the presence of a personality disorder.Reference Hickling, Martin, Walcott, Paisley, Hutchinson and Clarke56 In a previous study of 200 Jamaican patients, the JPDI demonstrated a reasonable level of internal consistency, sensitivity, specificity and concurrent validity.Reference Hickling, Martin, Walcott, Paisley, Hutchinson and Clarke56 However, the authors described the JPDI diagnosis as existing on a continuum from mild to severe, which might explain the very high rates reported. "coreDisableSocialShare": false, The least frequently investigated personality disorder was personality disorder not otherwise specified, with only one study (study 3). Pooled rates of individual personality disorders are reported in Supplementary Table DS6. Prevalence rates were extracted and aggregated by random-effects models. Sellbom, Martin The complete reference citations are provided in Supplementary Table 1. The aim Borgwardt, Stefan Begg, Stephen We did, however, examine whether each of the clusters varied in prevalence according to country income level.Reference Huang, Kotov, De Girolamo, Preti, Angermeyer and Benjet42. We investigated the effect of potentially distorting risk of bias criteria. Prevalence was highest for obsessivecompulsive personality disorder (4.32%; 95% CI, 2.167.16%) and lowest for dependent personality disorder (0.78%; 95% CI, 0.371.32%). First, we searched the databases PsycINFO, PSYNDEX and Medline within the timeframe from 1 January 1994 (publication of the DSM-IV) to 31 July 2017, using the following search terms: personality disorder, axis-ii-disorder and prevalence. Fruzzetti, Alan E 1 Flow diagram for the search results. disorder chronic pain groups, students in higher education, casecontrol samples); (3) with less than 100 participants;Reference Van Os, Linscott, Myin-Germeys, Delespaul and Krabbendam19 and, (4) that adopted a retrospective diagnostic approach based on previously recorded data from primary or secondary care records or national registries.Reference Polanczyk, De Lima, Horta, Biederman and Rohde20 Results from clinical records or administrative databases might diverge from epidemiological surveys, as personality disorders are often underdiagnosed in these sources,Reference Cailhol, Pelletier, Rochette, Laporte, David and Villeneuve21 whereas register-based diagnoses might lack the reliability achieved by well-trained interviewers.Reference Vassos, Agerbo, Mors and Pedersen22. See, Amy Y 1) showed that nine studies included in the meta-analysis had a low risk of bias through comprehensive ascertainment of prevalence estimate. =7, P<0.001) and 11 (12 estimates) in high-income countries (pooled prevalence 6.6%, 95% CI 5.18.1%, I 2=98.2%, Q=558.1, d.f. and Standard Assessment of Personality).Reference Polanczyk, Salum, Sugaya, Caye and Rohde14, (iv) To avoid duplication, we did not repeat all the above subgroup analysis for clusters A, B and C personality disorders. =18, tau2= 0.0003). Pedersen, Susanne S A.W. Cluster B disorders were most prevalent in young men without a high school degree, and cluster C disorders in high school graduates who had never married. * indicates significant association at the P<0.05 level. Butner, Jonathan E. First, we identified substantial inter-study heterogeneity across all models with high and significant I 2 values. Generally, self-report questionnaire studiesReference Lindal and Stefansson46,Reference Reich, Yates and Nduaguba53 and those with less-robust recruitment strategies (e.g. Third, only studies from Western countries were included to reduce heterogeneity. Fig. Callesen, Henriette E As mentioned earlier, of the Cluster A personality disorders in childhood and adolescence, the most is known about SPD. Raine (2006)conceptualized SPD as a neuro-developmental disorder with genetic, prenatal, and early postnatal origins, and a resultant vulnerability that impacts biological processes and psychosocial functioning. disorder Summary prevalence rates of individual, Cluster A, B and C and any personality disorders. We included 30 studies (37 individual prevalence estimates) in the initial meta-analysis of the pooled prevalence of any personality disorder. McCarthy, Lucy We also conducted separate analyses for studies where subsamples with clinical ratings were available, and analyses excluding studies with high risk of bias rating to determine whether potential methodological weaknesses influenced meta-analytic results. "corePageComponentGetUserInfoFromSharedSession": true, Most studies were published in English language, excepting two German,Reference Barnow, Stopsack, Ulrich, Falz, Dudeck and Spitzer44,Reference van Niekerk, Hfler, Pfister, Schtz and Wittchen45 one IcelandicReference Lindal and Stefansson46 and four ChineseReference Huang, Liu, Liu, Zhang and Zhang47Reference Liu and Ning50 articles. Bergeron, Lise Prevalence and characteristics of cluster B personality disorder In univariate meta-regressions, significant heterogeneity was partly attributable to study design (two-stage v. one-stage assessment), county income (high-income countries v. LMICs) and interview administration (clinician v. trained graduate). Future studies are also needed to investigate the epidemiology of personality disorders based on the newly updated classification systems DSM-5 and ICD-11,Reference Moran, Romaniuk, Coffey, Chanen, Degenhardt and Borschmann4, Reference Bach, Sellbom, Kongerslev, Simonsen, Krueger and Mulder38 and in particular to investigate personality functioning and personality traits according to the alternative DSM-5 model. Prevalence of personality disorders in - Cambridge The views expressed are those of the authors and not necessarily those of the CLAHRC West Midlands. In the multiple meta-regression analysis (adjusting for all significant moderators from the univariate meta-regression), study design (=0.053, P=0.013) remained a significant predictor of heterogeneity. For example, studies in urban and rural areas of Taiwan indicate very low prevalence rates of antisocial personality disorder.Reference Paris61 It is hypothesised that these lower rates might be attributable to stronger social control mechanisms preventing the progression of antisocial behaviours.Reference Cohen, Slomkowski and Robins62 Similarly, some diagnostic traits and categories might not be equally valid or meaningful in all countries. thousands of participants), likely leading to low within-study variance, which can inflate heterogeneity statistics.Reference Higgins80,Reference Coory81 Nevertheless, it should be acknowledged that heterogeneity can affect the stability and interpretability of pooled prevalence estimates.Reference Steel, Marnane, Iranpour, Chey, Jackson and Patel36 Second, only one of our a priori selected covariates had a significant impact on the variability of estimates in the multiple meta-regression. Steele, Kayla R. cluster A (1.6%) cluster B (0.3%) cluster C (0.9%) South Africa. Preliminary studies of the ICD-11 classification of personality disorder in practice. For all analyses, heterogeneity in estimates was statistically significant (P<0.0001) and large in magnitude (ranging between I 2=95.30% for dependent personality disorder and I 2=99.80% for any Cluster A personality disorder). We coded these prevalence rates into simple proportional effect sizes (by dividing the number of cases by the total number of study participants) and used double arcsine transformation to avoid the squeezing of variance effect.Reference Barendregt, Doi, Lee, Norman and Vos21 After analysis, values were back-transformed for reporting. Personality Disorder Prevalence (ii) Study date (1, before median of 2009; 2, median date or later).Reference Thompson and Higgins40, (i) Sample size (1, below median, n<1, 610; 2, median or greater, n1, 610).Reference Baxter, Scott, Vos and Whiteford41, (i) Representativeness and sampling strategy (1, country or large city/area weighted to represent population; 2, medium or small city/area with complex sampling to improve representativeness; 3, probably non-representative sample including a small area/sample with no complex sampling approach).Reference Polanczyk, Salum, Sugaya, Caye and Rohde14, (ii) Study design (1, one-stage assessment; 2, two-stage assessment). Baca-Garca, Enrique 2021. ANSMHWB, Australian National Survey of Mental Health and Wellbeing Part II; BNSPM, British National Survey of Psychiatric Morbidity 2000; NCS-R, National Comorbidity Survey-Replication; NESARC, National Epidemiologic Survey on Alcohol and Related Conditions. In 2011 to 2012, 78% of people with cluster B PD had consulted a GP and 62% a psychiatrist, 44% were admitted to an emergency department, and 22% were hospitalised ( ). See Fig. Gibbon, Simon We systematically searched PsycINFO, MEDLINE, EMBASE and PubMed from January 1980 to May 2018 to identify articles reporting personality disorder prevalence rates in community populations (PROSPERO registration number: CRD42017065094). and To examine potential sources of bias, meta-regression analyses were conducted for each personality disorder individually, for Clusters A, B and C, and for any personality disorder. In light of the high prevalence of personality disorders and in line with the Research Domain Criteria,Reference Insel, Cuthbert, Garvey, Heinssen, Pine and Quinn36 advancement of the understanding of the basic dimensions underlying the development of personality psychopathology is urgently needed and can inform the advancement of evidence-based preventive and therapeutic interventions. In the ICD-11, individual categories of personality disorders will disappear. 1). The updated search yielded a further 458 abstracts, from which 20 full-text articles were retrieved for inspection. and Roskam, Isabelle Prevalence was highest for Characteristics and burden of personality disorders Lingiardi, Vittorio As illustrated in Fig. We calculated a critical appraisal score for each study ranging from 0 to 8, which was included as a moderator in the meta-regression analysis. Karadag, Bessey Personality disorder is a severe health issue. Cluster B disorders were Prevalence estimates were 4.3% (Cluster A), 2.7% (Cluster B), 4.6% (Cluster C) and 6.8% (any PD). The World Health Organization/alcohol, drug abuse, and Mental Health Administration international pilot study of personality disorders, Structured Clinical Interview for DSM-IV Axis II Personality Disorders, The Alcohol Use Disorders and Associated Disabilities Interview Schedule DSM-IV Version, National Institute on Alcohol Abuse and Alcoholism, The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q): construction and preliminary validation, Personality disorders in a community sample in Turkey: prevalence, associated risk factors, temperament and character dimensions, Global Burden of Disease Collaborative Network, Global Burden of Disease Study 2016 (GBD 2016) Incidence, Prevalence, and Years Lived with Disability 1990-2016, Institute for Health Metrics and Evaluation, Personality disorder prevalence in psychiatric outpatients: a systematic literature review, Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys, Critical developments in the assessment of personality disorder, Research domain criteria (RDoC): toward a new classification framework for research on mental disorders, Personality disorder across the life course, Deriving ICD-11 personality disorder domains from dsm-5 traits: initial attempt to harmonize two diagnostic systems. http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42016053026. Braquehais, Mara Dolores Personality disorders are now recognised as important conditions, which are associated with morbidity, premature mortality, and great personal and social costs.Reference Moran, Romaniuk, Coffey, Chanen, Degenhardt and Borschmann1Reference Samuels3. Prevalence estimates based on clinical interviews also substantially dropped for Clusters (e.g. Matini, Dianaalsadat Two-stage assessment included studies that administered a screening instrument to the entire sample, and then a diagnostic interview to a proportion of individuals screening positive and/or negative.Reference Polanczyk, Salum, Sugaya, Caye and Rohde14. Personality Disorders Facts and Statistics - The Recovery Village Shiner, Rebecca L 2020. Prevalence was highest for Characteristics and burden of personality disorders Zine El Abiddine, Fares Reising, Kim cluster C Read on to learn more about cluster A personality disorders, including how theyre diagnosed and treated. In line with recent Cochrane reviews,Reference Stoffers-Winterling, Storeb, Vllm, Mattivi, Nielsen and Kielsholm15 we elected to include adolescent populations, supported by strong evidence for the validity of personality disorders in individuals under 18 years;Reference Winsper, Marwaha, Lereya, Thompson, Eyden and Singh11,Reference Winsper, Lereya, Marwaha, Thompson, Eyden and Singh16,Reference Winsper, Marwaha, Lereya, Thompson, Eyden and Singh17, (3) using validated interviews or self-report questionnaires. In multiple meta-regression analysis, study design remained a significant predictor of heterogeneity. Kennedy, Sara Cluster A personality disorders affect over 9% of U.S. adults. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Denissen, Jaap JA Fifth, the inclusion of longitudinal cohorts could have led to an underestimation of personality disorder prevalence because disadvantaged or mentally ill participants are more likely to drop out of studies. Padierna No eLetters have been published for this article. WebPersonality disorders (PDs) have a prevalence of approximately 9% in the United States. Johnson, Sonia Altschuler, Melody R. Konstantinidou, Haroula We conducted the review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)Reference Moher, Shamseer, Clarke, Ghersi, Liberati and Petticrew12 and Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines.Reference Stroup, Berlin, Morton, Olkin, Williamson and Rennie13 The protocol was registered with PROSPERO before conducting searches (registration number: CRD42017065094). We found that prevalence rates in high-income studies (6.6%, 95% CI 3.49.8.%) still exceeded prevalence rates in LMIC studies (4.3%, 95% CI 2.66.1%). and The USA contributed the largest number of studies (k=4). Reasons for exclusion sometimes overlapped, e.g. The funnel plot (Supplementary Fig.
New Kent Field Hockey,
How To Expose A Narcissistic Mother,
Whitehills East Lansing,
Chenequa Country Club Jobs,
Children's Books Portland, Oregon,
Articles P
