Personality disorders: community prevalence and socio-demographic correlates

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Highlights

  • •

    Each personality disorder diagnosis is relatively uncommon in community samples.

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    The presence of any personality disorder occurs with notable frequency.

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    Our meta-analytic approach yielded stable community prevalence estimates.

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    Rank-order stability of personality disorder prevalence rates across studies is weak.

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    Personality disorders are associated with numerous socio-demographic correlates.

Multiple studies have reported community prevalence rates of personality disorders (PDs), but these studies differed in terms of diagnostic criteria, assessment instruments, communities sampled, and size, producing widely ranging estimates. We take a meta-analytic approach to characterizing PD community prevalence rates by comparing results from two reviews that pooled previous studies. Overall, particular PD rates are low in community samples, but the presence of any PD is relatively high, with approximately one person in seven experiencing personality psychopathology. High congruence of prevalence estimates, but low rank-order agreement of rates, was observed. We discuss how the presence of PD is associated with socio-demographic correlates such as gender, race/ethnicity, and age and highlight areas for further study.

Section snippets

Community prevalence of PDs: a meta-analytic approach

Numerous published studies have characterized prevalence rates of PDs. These studies differ with regard to diagnostic criteria used (e.g. DSM-III-R versus DSM-5), assessment methodology (e.g. questionnaires, interviews), characteristics of the community sampled (e.g. nationality), sample size, and so on. This has produced a piecemeal literature that is difficult to integrate into a coherent whole. These issues, coupled with relatively low prevalence rates of some PDs, suggest that individual

General findings

Although prevalence estimates from individual studies often differed notably, pooled results from the two meta-studies conducted by Torgersen and colleagues [7] and Samuels [6] suggest relatively similar estimates. For instance, pooled estimates for individual PD prevalence rates across the two studies differed by a median of only 0.5%, and differences in these pooled estimates ranged from 0.1% (schizoid) to around 2.5% (histrionic). These findings indicate that, when pooling multiple studies,

Socio-demographic correlates

PDs are consistently linked with various socio-demographic characteristics. We focus our attention on the most widely reported of these.

Gender. Across studies, gender differences across PDs have emerged consistently [6, 18, 19, 21, 23, 26•]. For instance, Trull and colleagues [21] found that men had lower odds of all PDs compared to women, except for schizoid (odds ratio [OR] = 1.2), narcissistic (1.6), and antisocial (3.0). However, there is evidence of gender bias within PD diagnostic criteria [

Summary

Individual PD community prevalence rates differ markedly across studies, and each diagnosis tends to be infrequent. The presence of any PD, however, is relatively common, suggesting a notable community public health concern [38•, 39]. Pooled results from multiple studies produce generally stable PD prevalence estimates, even across different communities, diagnostic criteria, and assessments; however, the rank-order of PDs by community prevalence differs markedly across studies. PDs are also

Conflict of interest statement

Nothing declared.

References and recommended reading

Papers of particular interest, published within the period of review, have been highlighted as:

  • • of special interest

  • •• of outstanding interest

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