Conclusions

Up to 20 years ago, the epidemiology of PDs had not received the same amount of attention as that of many other psychiatric disorders. Since then the situation has changed, and we now have data on the prevalence of PD in the community and in psychiatric facilities. Community data come primarily from eight studies, with a total sample of 4518 subjects from three countries (Germany, the United Kingdom, and the United States). There are excellent national and cross-national epidemiological data on antisocial personality disorder based on the same diagnostic methods. There are almost no data on other PDs from countries other than the United States, the United Kingdom, and Germany.

One important methodological problem is that some PDs have a very low prevalence rate. Consequently, epidemiological surveys carried out among the general population may require very large samples in order to identify a ufficient number of cases to study demographic correlates and the association of PD with other psychiatric disorders. Future studies should try to address this problem and provide us with more definite epidemiological data. These data will also be invaluable in showing the validity of current classifications and in better delineating the boundaries between different PDs.

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