Personality disorders are categorized into three clusters in the Diagnostic and Statistical Manual of Mental Disorders, DSM-5: cluster A, cluster B and cluster C. Cluster A personality disorders are described as odd and eccentric, cluster B as dramatic and erratic and cluster C as anxious and fearful. Oram, Sian all one-step studies were from high-income countries, potentially inflating the gap between high-income countries and LMICs). Diagnostic criteria of personality disorders have been criticised for their low discriminant validity and overlap of many criteria, which is associated with high comorbidity and low clinical utility. With regard to individual personality disorders, the prevalence rate is highest for obsessivecompulsive personality disorder (4.32%), and lowest for dependent personality disorder (0.78%). Viswanathan, Meera The primary outcome of this meta-analysis was the prevalence rate of personality disorders. We defined the coding procedure a priori and made adaptations in the course of data abstraction (e.g. First, the literature search was limited to articles published in English or German. "coreUseNewShare": false, Despite our comprehensive search, we only identified a modest number of epidemiological studies. The worldwide pooled prevalence of any personality disorder was 7.8% (95% CI 6.19.5). Second, we used the ancestry and descendant approach, searching reference lists and citing articles of included articles and other relevant studies.Reference Tyrer, Reed and Crawford9, Reference Torgersen, Kringlen and Cramer12, Reference Huang, Kotov, de Girolamo, Preti, Angermeyer and Benjet15 The study is registered with PROSPERO under the record CRD42016053026 (http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42016053026). and Prevalence and characteristics of cluster B personality disorder WebGlobal rates of cluster A, B and C personality disorders were 3.8% (95% CI 3.2, 4.4%), 2.8% (1.6, 3.7%) and 5.0% (4.2, 5.9%). With regard to the overall risk of bias rating for individual studies, seven studies achieved a low risk of bias rating (4 points) and three studies achieved a high risk of bias (<4 points) according to the rating with the adapted NOS. We use cookies to distinguish you from other users and to provide you with a better experience on our websites. WebAnswer (1 of 5): I have answered variations of this question before, but not for Cluster B as a whole. Results. Personality Disorder Prevalence "coreDisableEcommerceForArticlePurchase": false, Prevalence Cluster C (also known as anxious-fearful) personality disorder included any categorical avoidant, dependent or obsessivecompulsive personality disorder.26 We also pooled the prevalence rates of individual personality disorders (e.g. 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. Personality Disorders Facts Gartlehner, Gerald Salcuni, Silvia cluster A (1.6%) cluster B (0.3%) cluster C (0.9%) South Africa. Nevertheless, pooled prevalence rates should be interpreted with caution due to high levels of heterogeneity. Weboverall, cluster B personality disorders least prevalent (1.5%) compared with cluster A (3.6%) and cluster C (2.7%) estimated prevalence in surveyed regions. Data on differential diagnosis were only found with cluster A and cluster B PD. Bjrkenstam, Charlotte Because of the large heterogeneity in prevalence rates, a larger authoritative database on the epidemiology of personality disorders in the general adult population is required. Cumulative exposure to violence was associated with all PDs except Cluster A, although urbanicity, migration and neighborhood social deprivation were not significant predictors. then independently screened full-text articles for inclusion in the review. Helweg-Jrgensen, Stig Cluster A disorders were most prevalent in men who had never married. Curc, George-Cristian The first thing to note is most of the Cluster B types are not going to present REML, restricted maximum likelihood method; LMICs, low- and middle-income countries; N/A, not applicable; SCID-II, Structured Clinical Interview for DSM-IV; IPDE, International Personality Disorder Examination; SIDP, Structured Interview for DSM-IV Personality. The pooled prevalence of any personality disorder was significantly lower in LMICs (4.3%) than in high-income countries (9.4%) in univariate meta-regression, although this difference became non-significant in the final meta-regression. Khalifa, Najat R 2021. (i) Diagnostic criteria according to the two most-used systems in psychiatry, the ICD and the DSM (1, ICD-8 [1967]/-9 [1978]/-10; 2, DSM-III-R [1980]; 3, DSM-IV).Reference Polanczyk, Salum, Sugaya, Caye and Rohde14, (ii) Interview administration (1, interview by experienced clinician or psychiatrist; 2, interview by trained graduates or research assistants; 3, interview by trained lay person).Reference Baxter, Scott, Vos and Whiteford41, (iii) Diagnostic interview (1, clinical interview; 2, Structured Clinical Interview for DSM-IV [SCID-II]; 3, International Personality Disorder Examination [IPDE]; 4, Structured Interview for DSM-IV Personality/Revised [SIDP-IV]; 5, other, e.g. Cluster A personality disorders affect over 9% of U.S. adults. The structure of personality pathology: both general (g) and specific (s) factors? Self-report measures, which are more economic to use, have been criticised for overestimating prevalence, whereas diagnostic interviews require clinical expertise, intensive training and are more time consuming.Reference Tyrer, Coombs, Ibrahimi, Mathilakath, Bajaj and Ranger35 One study in particular (study 9) was consistently associated with large variations in prevalence estimates, which may also be associated with the use of a self-report measure in this study. translated and extracted data from the Chinese publications. Pooled rates of individual personality disorders are reported in Supplementary Table DS6. As illustrated in Fig. We examined eight categories: (a) representativeness of target population, (b) recruitment of participants, (c) sample size, (d) description of study participants and setting, (e) coverage of identified sample, (f) objectivity of assessment, (g) reliability of the assessment and (h) appropriate statistical analysis. The participants age ranged from 16 to 94 years, with a mean age range from 33 to 51 years. Tanzilli, Annalisa The relatively high global prevalence of cluster A personality disorders contrasts with low presentation of these disorders in clinical settings.Reference Soeteman, Roijen, Verheul and Busschbach73 These three personality disorders (paranoid, schizoid and schizotypal) often receive the least research attentionReference Bateman, Gunderson and Mulder74 despite being associated with chronic physical comorbidities, including cardiovascular disease, arthritis and high levels of functional impairment.Reference Quirk, Berk, Chanen, Koivumaa-Honkanen, Brennan-Olsen and Pasco4, We noted that studies from Australia tended to report high personality disorder prevalence rates, although estimates varied across studies. Mental Disorders: Personality Disorders Patients with these disorders frequently are encountered in the family medicine setting. and Aluja, Anton The most common personality disorders were obsessivecompulsive (3.2%), avoidant (2.7%) and paranoid (2.3%) personality disorders. Also, for the DSM diagnosis personality disorder not otherwise specified, which is commonly used in clinical practice, only one study was included in our analysis. Personality disorders are prevalent globally. Personality Disorder Prevalence First, there might exist a lower population risk in LMICs due to key cultural or social factors.Reference Tyrer, Mulder, Crawford, Newton-Howes, Simonsen and Ndetei2,Reference Steel, Marnane, Iranpour, Chey, Jackson and Patel36,Reference Gawda and Czubak58,Reference Cheng, Huang, Liu and Liu59 Previous global reviews indicate lower rates of depression and anxiety in LMICs,Reference Steel, Marnane, Iranpour, Chey, Jackson and Patel36,Reference Ferrari, Somerville, Baxter, Norman, Patten and Vos60 and it is plausible that variations in behavioural norms across countries (e.g. Cluster A disorders were most prevalent in men who had never married. Crawford, Mike Further large-scale, multi-country studies with standardised methodologies are needed to shed further light on whether true differences exist,Reference Huang, Kotov, De Girolamo, Preti, Angermeyer and Benjet42 although current diagnostic tools may not adequately capture subtle cultural nuances.Reference Balaratnasingam and Janca72, Cluster A personality disorders were relatively common in high-income countries (4.2%) and LMICs (3.4%). Data on differential diagnosis were only found The final sample comprised ten studies (published in 27 articles), which met the inclusion criteria for this meta-analysis (see Fig. and prevalence We did not limit to a specific diagnostic criteria (e.g. The relatively high global prevalence of cluster A personality disorders contrasts with low presentation of these disorders in clinical settings. Data comes from seven different countries: Australia (study 7), Germany (study 6), the Netherlands (study 10), Sweden (study 5), Turkey (study 9), UK (study 8) and USA (studies 1, 2, 3 and 4). =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. Simpson, Alan We inspected the reference lists of retrieved articles and cross-referenced our findings against published reviews.Reference Tyrer, Mulder, Crawford, Newton-Howes, Simonsen and Ndetei2Reference Quirk, Berk, Chanen, Koivumaa-Honkanen, Brennan-Olsen and Pasco4,Reference Paris23,Reference Sansone and Sansone24 Following removal of duplicates, C.W. A total of 46 studies (from 21 different countries spanning 6 continents) satisfied inclusion criteria. Other factors, such as diagnostic assessment, had a noticeable effect on pooled prevalence rates in the subgroup analysis, but were not significant predictors in the meta-regression. The metaprop command is an extension of the metan procedure designed for meta-analysis of proportions. 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 disorders. Fig. Ramos-Quiroga, Josep Antoni Warren, Fiona has full access to the data in the study and takes responsibility for the integrity of the data and accuracy of the analysis. 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Di Cicilia, Giuseppe Karadag, Bessey We conducted sensitivity analysis to evaluate the influence of each study on pooled personality disorder prevalence using the metaninf command.Reference Taylor and Kim-Cohen31 We also examined the impact of self-report questionnaires on prevalence figures, as they have been associated with the over-diagnosis of personality disorders.Reference Dereboy, Gzel, Dereboy, Okyay and Eskin32,Reference Yang, Coid and Tyrer33 We compared pooled rates of self-report questionnaire versus interview studies. and and 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. Ekselius, Lisa With regard to specific personality disorders, the overall random-effects estimates ranged from 0.78% for dependent personality disorder (95% CI, 0.371.32%, I 2=95.30%, Q=127.54, P<0.0001) to 4.32% for obsessivecompulsive personality disorder (95% CI, 2.167.16%, I 2=99.30%, Q=808.40, P<0.0001). Nevertheless, there are no systematic reviews examining the global prevalence of personality disorders. We found that heterogeneity, although slightly reduced, remained high across all subgroup analyses. With regard to DSM Clusters, the overall random-effects estimate excluding study 9 was 5.20 (95% CI, 1.0712.16%) for any Cluster A, 3.72 (95% CI, 1.936.06%) for any Cluster B, and 4.93 (95% CI, 1.659.82%) for any Cluster C (Table 2). and Riipinen, Pirkko in studies measuring prevalence there are no negative findings) and that specific methods for prevalence reviews are not well established.Reference Bui, Rahman, Heywood and MacIntyre84,Reference Shaikh, Morone, Bost and Farrell85 Third, there were some potential moderating factors we could not include in our analysis due to insufficient data, or a difficulty in constructing meaningful categories. A total of 34 studies reported a prevalence figure for any personality disorder and/or cluster A, B or C personality disorder (some of these studies also reported a prevalence figure for an individual personality disorder). "coreDisableSocialShare": false, The final sample comprised ten studies, with a total of 113 998 individuals. Mansouri, Mohammad Reza Autism spectrum disorder and personality disorders: Comorbidity Has data issue: false Jewell, Mahlie Please refer to Supplementary Table DS4 for an overview of the risk-of-bias analysis. 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. Interrater reliability was acceptable (kappa 0.82). prevalence Schizotypal (0.8%), histrionic (0.6%) and dependent (0.8%) personality disorders were rare. and National Epidemiologic Survey of Alcohol and Related Conditions), the use of selected samples (e.g. Jeynes, Tamar Cluster B patients were compared with the remaining patients. Results: Eleven point six percent of these patients were diagnosed with a cluster B-PD. Thus, in line with previous studies,Reference de Noordhout, Devleesschauwer, Angulo, Verbeke, Haagsma and Kirk51,Reference Frhauf, Gerger, Schmidt, Munder and Barth52 we used Google Translate for these articles. Fruzzetti, Alan E Furthermore, the course of personality disorders needs to be investigated.Reference Newton-Howes, Clark and Chanen37 For some personality disorders, it has been argued that specific symptoms decline with age, e.g.