Personality disorder epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief:
Overview
Worldwide pooled prevalence of personality disorder as found by meta-analysis of studies conducted from 21 countries is 7.8%. Global rates of cluster-A PD is 3.8%, cluster-B is 2.8% and cluster-C PD is 5% [1]. In United States (US), it is around 10%, with major disease burden contributed by obsessive-compulsive PD followed by narcissist and borderline PD. In the rest of countries, it varies [2]. OCD is twice common in females than males and 75% of individuals diagnosed with BPD are females. No sex predilection is found with rest. Narcissist PD is found in 20% of military personals, 17% first-year medical students and 6% forensic population.
Epidemiology and Demographics
Prevalence
The prevalence of personality disorder in the general community was largely unknown until surveys starting from the 1990s. In 2008 the median rate of diagnosable PD was estimated at 10.6%, based on six major studies across three nations. This rate of around one in ten, especially as associated with high use of services, is described as a major public health concern requiring attention by researchers and clinicians.[3]. According to the National Co-morbidity Study Replication (NCS-R), the prevalence of personality disorders in 18 years and older in the last year was 9.1%. It was a nationally conducted household survey between 2001-2003. [4].
The prevalence of individual personality disorders ranges from about 2% to 3% for the more common varieties, such as schizotypal, antisocial, borderline, and histrionic, to 0.5–1% for the least common, such as narcissistic and avoidant.
A screening survey across 13 countries by the World Health Organization using DSM-IV criteria, reported in 2009 a prevalence estimate of around 6% for personality disorders. The rate sometimes varied with demographic and socioeconomic factors, and functional impairment was partly explained by co-occurring mental disorders.[5] In the US, screening data from the National Comorbidity Survey Replication between 2001 and 2003, combined with interviews of a subset of respondents, indicated a population prevalence of around 9% for personality disorders in total. Functional disability associated with the diagnoses appeared to be largely due to co-occurring mental disorders (Axis I in the DSM).[6]. According to the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), the most common PD in US is Obsessive-compulsive PD which is 7.9% followed by narcissistic 6.2% and boderline PD 5.9%. [2]
A meta-analysis conducted to calculate global prevalence of personality disorders in 2020 by Winsper et al. revealed the worldwide pooled prevalence to be around 7.8%. [1].
The studies regarding epidemiology of individual types of PDs are lacking. According to National Institute of Health (NIH), the point prevalence of BPD is 1.6% and lifetime prevalence is 5.9%. [7] The data by NESARC revealed no difference in gender for prevalence of BPD. The prevalence of paranoid in US ranges between 2.3-4.4% and more common in males. [8] The 2004-2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions demonstrated that the prevalence of schizotypal PD to be around 3.9% with greater rate in males as compared to females. [9]. For Narcissistic PD, the prevalence was found to be 6.2% in US people aged 18 years and above with higher rates for male population. [10].
The prevalence of PDs according to NCS and NESARC are summarised as follows: [11]
| Prevalence of personality disorders | ||
|---|---|---|
| Type of personality disorder | NCS | NESARC |
| Paranoid personality disorder | - | 1.9 |
| Schizoid personality disorder | - | 0.6 |
| Schizotypal personality disorder | - | 0.6 |
| Antisocial personality disorder | 0.6 | 3.8 |
| Borderline personality disorder | 1.4 | 2.7 |
| Histrionic personality disorder | - | 0.3 |
| Narcissistic personality disorder | - | 1.0 |
| Avoidant personality disorder | - | 1.2 |
| Dependent personality disorder | - | 0.3 |
| Obsessive–compulsive personality disorder | - | 1.9 |
There are also some gender differences in the frequency of personality disorders. They are shown in the table below.
| Gender differences in the frequency of personality disorders | |
|---|---|
| Type of personality disorder | Sex |
| Paranoid personality disorder | Male |
| Schizoid personality disorder | Male |
| Schizotypal personality disorder | Male |
| Antisocial personality disorder | Male |
| Borderline personality disorder | Female or No difference |
| Histrionic personality disorder | Female |
| Narcissistic personality disorder | Male |
| Avoidant personality disorder | Equal |
| Dependent personality disorder | Female |
| Obsessive–compulsive personality disorder | Male |
References
- ↑ 1.0 1.1 Winsper C, Bilgin A, Thompson A, Marwaha S, Chanen AM, Singh SP; et al. (2020). "The prevalence of personality disorders in the community: a global systematic review and meta-analysis". Br J Psychiatry. 216 (2): 69–78. doi:10.1192/bjp.2019.166. PMID 31298170.
- ↑ 2.0 2.1 Sansone RA, Sansone LA (2011). "Personality disorders: a nation-based perspective on prevalence". Innov Clin Neurosci. 8 (4): 13–8. PMC 3105841. PMID 21637629.
- ↑ Lenzenweger, Mark F. (2008). "Epidemiology of Personality Disorders". Psychiatric Clinics of North America. 31 (3): 395–403. doi:10.1016/j.psc.2008.03.003. PMID 18638642.
- ↑ "NIMH » Personality Disorders".
- ↑ Huang, Y. (30 June 2009). "DSM-IV personality disorders in the WHO World Mental Health Surveys". The British Journal of Psychiatry. 195 (1): 46–53. doi:10.1192/bjp.bp.108.058552. PMC 2705873. PMID 19567896. Unknown parameter
|coauthors=ignored (help) - ↑ Lenzenweger, Mark F. (2006). "DSM-IV Personality Disorders in the National Comorbidity Survey Replication". Biological Psychiatry. 62 (6): 553–564. doi:10.1016/j.biopsych.2006.09.019. PMC 2044500. PMID 17217923. Unknown parameter
|coauthors=ignored (help) - ↑ Lenzenweger MF, Lane MC, Loranger AW, Kessler RC (2007). "DSM-IV personality disorders in the National Comorbidity Survey Replication". Biol Psychiatry. 62 (6): 553–64. doi:10.1016/j.biopsych.2006.09.019. PMC 2044500. PMID 17217923.
- ↑ "tule.pw" (PDF).
- ↑ Pulay AJ, Stinson FS, Dawson DA, Goldstein RB, Chou SP, Huang B; et al. (2009). "Prevalence, correlates, disability, and comorbidity of DSM-IV schizotypal personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions". Prim Care Companion J Clin Psychiatry. 11 (2): 53–67. doi:10.4088/pcc.08m00679. PMC 2707116. PMID 19617934.
- ↑ Stinson FS, Dawson DA, Goldstein RB, Chou SP, Huang B, Smith SM; et al. (2008). "Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions". J Clin Psychiatry. 69 (7): 1033–45. doi:10.4088/jcp.v69n0701. PMC 2669224. PMID 18557663.
- ↑ Trull TJ, Jahng S, Tomko RL, Wood PK, Sher KJ (2010). "Revised NESARC personality disorder diagnoses: gender, prevalence, and comorbidity with substance dependence disorders". J Pers Disord. 24 (4): 412–26. doi:10.1521/pedi.2010.24.4.412. PMC 3771514. PMID 20695803.