Community epidemiological studies of unspecified personality disorders

Until the development of the DSM-III diagnostic criteria for PD and the subsequent availability of standardized assessment instruments, epidemiological studies aimed at assessing the prevalence rate of PDs were hampered by severe methodological limitations, including differences in sampling methods and in diagnostic criteria, the known unreliability of PD diagnoses based on clinical judgement, and the lack of standardized assessment methods. Since 1980, eight studies have ascertained the prevalence rate of PDs in different community samples using assessment instruments specific for PD; they are shown in Table 1,

Table 1 Prevalence rates of personality disorders in epidemiological surveys

In these studies, the sample sizes ranged between 200 and 1646 subjects, with an average sample of 564; all surveyed individuals (all randomly selected) were evaluated by means of a specific PD assessment instrument, mainly a structured interview. While most studies were carried out in one stage, Lenzenweger et al.(3,) first screened a large sample of university students with a self-administered Axis II inventory, and then interviewed a subgroup of 258 subjects using the International Personality Disorder Examination. The median prevalence rate of any PDs in these eight studies is 10.5 per cent.

In the surveys considered here the rate of PDs decreases in older age groups; although the sex ratio is different for specific types of PD (e.g. more antisocial PDs among males, more dependent and anxious PDs among females), the overall rates of PD are about equal for both sexes. Finally, prevalence rates are generally higher in urban populations and lower socio-economic groups.

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