Co-morbidity of personality disorder in schizophrenia among psychiatric outpatients in China: data from epidemiologic survey in a clinical population
Open accessAbstract
BACKGROUND: The reported rates of personality disorder (PD) in subjects with schizophrenia (SZ) are quite varied across different countries, and less is known about the heterogeneity of PD among subjects with SZ. We examined the co-morbidity of PD among patients who are in the stable phase of SZ. METHOD: 850 subjects were randomly sampled from patients diagnosed with SZ in psychiatric and psycho-counseling clinics at Shanghai Mental Health Center. Co-morbidity of PDs was assessed through preliminary screening and patients were administered several modules of the SCID-II. Evidence of heterogeneity was evaluated by comparing patients diagnosed with SZ with those who presented with either affective disorder or neurosis (ADN). RESULTS: 204 outpatients (24.0 %) in the stable phase of SZ met criteria for at least one type of DSM-IV PD. There was a higher prevalence of Cluster-A (odd and eccentric PD) and C (anxious and panic PD) PDs in SZ (around 12.0 %). The most prevalent PD was the paranoid subtype (7.65 %). Subjects with SZ were significantly more likely to have schizotypal PD (4.4 % vs. 2.1 %, p = 0.003) and paranoid PD (7.6 % vs. 5.4 %, p = 0.034), but much less likely to have borderline, obsessive-compulsive, depressive, narcissistic and histrionic PD. CONCLUSIONS: These findings suggest that DSM-IV PD is common in patients with SZ than in the general population. Patterns of co-morbidity with PDs in SZ are different from ADN.
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BPD is often overlooked in psychiatric practice in China.
“However, despite BPD being classified as a Cluster B personality disorder (PD), it is often overlooked in the psychiatric practice in China (5, 6).”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [5]
The Discussion says Chinese psychiatric professionals give little attention to co-occurring personality disorders in routine assessments of patients with schizophrenia. The Methods identifies borderline personality disorder as a Cluster B disorder, but the paper does not specifically say BPD is often overlooked or establish that this applies across psychiatric practice in China. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe PDQ-4+ has high sensitivity (0.89) and acceptable specificity (0.65) for screening DSM-IV PDs among Chinese psychiatric patients.
“The PDQ-4+ has high sensitivity (0.89) and acceptable specificity (0.65), making it a widely used tool for screening DSM-IV PDs among Chinese psychiatric patients.”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [5]
The Method section (Assessment tools of personality disorders and procedures; page unavailable) says the PDQ-4+ is widely used to screen for DSM-IV personality disorders, gives its sensitivity as 0.89, and describes its specificity as medium. It does not give a specificity of 0.65, so that numerical part of the claim is unsupported by our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe PDQ-4+ has high test-retest reliability (0.92) in the Chinese population.
“It has demonstrated high test-retest reliability (0.92) in the Chinese population, confirming its consistency in producing reliable results (5, 14, 21).”
From Age-related differences in borderline personality disorder traits and childhood maltreatment: a cross-sectional study (2025) · cites this paper as [5]
The Method section (Assessment tools of personality disorders and procedures; page unavailable) says the PDQ-4+ was used in a Chinese clinical sample and reports sensitivity of 0.89, not test–retest reliability. Searches for “0.92,” test–retest reliability, and psychometric validation found no passage supporting the claimed reliability figure. (LLM, conf=0.76)
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- Authors
- Wei, Y., Zhang, T., Chow, A., Tang, Y., Xu, L., Dai, Y., Liu, X., Su, T., Pan, X., Cui, Y., Li, Z., Jiang, K., Xiao, Z., Tang, Y., & Wang, J.
- Affiliations
- Second Military Medical University (CN)
- Shanghai Jiao Tong University (CN)
- Changi General Hospital (SG)
- Corresponding author
- Tang, YingYing
- Venue
- BMC Psychiatry
- Published
- 2016-07-08
- Volume
- 16
- Issue
- 1
- Pages
- 224-224
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC4939030
- OpenAlex
- W2461268822
- Cited by
- 23
- References
- 52
- Citations by year
- 2025: 3 · 2024: 4 · 2022: 3 · 2021: 7 · 2019: 1 · 2018: 3 · 2017: 2
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Greater South Information System
- Funders
- National Natural Science Foundation of China (CN) (81201043, 81372122, 81261120410, 81361120403)
- The 12th Five-Year projects of PLA research (NO.13QJ003-005)
- Shanghai Science and Technology Committee (15411967200, 14411961400)
- National Key Clinical Disciplines at Shanghai Mental Health Center (OMA-MH, 2011-873)
- Shanghai Key Laboratory of Psychotic Disorders (13dz2260500)
- Shanghai Jiao Tong University Foundation (14JCRY04, YG2014MS40)
- Mental Health Application Research in PLA (NO.12XLZ109)
- SHSMU-ION Research Center for Brain Disorders (2015NKX001)
- Shanghai health system advanced appropriate technology (2013SY003)
- Shanghai education science research project (No.B13028)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Keywords
- schizophrenia, personality disorders, comorbidities, paranoid personality disorder, schizotypal personality disorder, Cluster A personality disorders, cluster C personality disorders, psychiatric outpatients, prevalence, DSM-IV personality disorders
- MeSH terms
- Adult, China, Female, Health Surveys, Humans, Male, Middle Aged, Outpatients, Personality Disorders, Schizophrenia, Schizophrenic Psychology, Comorbidity, Prevalence, Diagnostic and Statistical Manual of Mental Disorders
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