The prevalence of personality disorders in the community: a global systematic review and meta-analysis

Published on Feb 1, 2020in British Journal of Psychiatry7.85
· DOI :10.1192/BJP.2019.166
Catherine Winsper21
Estimated H-index: 21
(Warw.: University of Warwick),
Ayten Bilgin9
Estimated H-index: 9
(Istanbul Medeniyet University)
+ 5 AuthorsVivek Furtado11
Estimated H-index: 11
(Warw.: University of Warwick)
Background Personality disorders are now internationally recognised as a mental health priority. Nevertheless, there are no systematic reviews examining the global prevalence of personality disorders. Aims To calculate the worldwide prevalence of personality disorders and examine whether rates vary between high and low and middle-income countries (LAMICs). Method We systematically searched PsycINFO, MEDLINE, EMBASE and PubMed from 1980 to May 2018 to identify articles reporting personality disorder prevalence rates in community populations (PROSPERO registration number: CRD42017065094). Results Forty-six studies (from 21 different countries spanning six continents) satisfied inclusion criteria. The worldwide pooled prevalence of any personality disorder was 7.8 % (95% Confidence Intervals: 6.1-9.5). Rates were greater in high income (9.6%; 95% CI: 7.9-11.3%) compared with LAMI (4.3%; 95% CI =2.6-6.1%) countries. In univariate meta-regressions, significant heterogeneity was partly attributable to study design (two-stage versus one-stage assessment), county income (high versus LAMI) and interview administration (clinician versus trained graduate). In multiple meta-regression analysis, study design remained a significant predictor of heterogeneity. Global rates of Cluster-A, B and C personality disorders were 3.8 % (3.2, 4.4%), 2.8% (1.6, 3.7%) and 5.0% (4.2, 5.9%). Conclusions Personality disorders are prevalent globally. Nevertheless, pooled prevalence rates should be interpreted with caution due to high levels of heterogeneity. More large-scale studies with standardised methodologies are now needed to increase our understanding of population needs and regional variations.
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