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

Catherine Winsper, Ayten Bilgin, Andrew Thompson, Steven Marwaha, Andrew M Chanen, Swaran P Singh, Ariel Wang, Vivek Furtado

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Abstract

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.
Original languageEnglish
JournalBritish Journal of Psychiatry
Early online date12 Jul 2019
DOIs
Publication statusE-pub ahead of print - 12 Jul 2019

Keywords

  • personality disorder
  • prevalence
  • systematic review
  • meta-analysis
  • LMIC

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