DSM-IV personality disorders in the WHO World Mental Health Surveys
Open accessAbstract
Background: Little is known about the cross-national population prevalence or correlates of personality disorders. Aims: To estimate prevalence and correlates of DSM–IV personality disorder clusters in the World Health Organization World Mental Health (WMH) Surveys. Method: International Personality Disorder Examination (IPDE) screening questions in 13 countries (n = 21 162) were calibrated to masked IPDE clinical diagnoses. Prevalence and correlates were estimated using multiple imputation. Results: Prevalence estimates are 6.1% (s.e. = 0.3) for any personality disorder and 3.6% (s.e. = 0.3), 1.5% (s.e. = 0.1) and 2.7% (s.e. = 0.2) for Clusters A, B and C respectively. Personality disorders are significantly elevated among males, the previously married (Cluster C), unemployed (Cluster C), the young (Clusters A and B) and the poorly educated. Personality disorders are highly comorbid with Axis I disorders. Impairments associated with personality disorders are only partially explained by comorbidity. Conclusions: Personality disorders are relatively common disorders that often co-occur with Axis I disorders and are associated with significant role impairments beyond those due to comorbidity.
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Personality disorders are common mental disorders associated with a wide range of difficulties, including alcohol and drug problems, poorer general health, long-term unemployment and reduced life expectancy.
“Epidemiological research has confirmed that personality disorders are common mental disorders 1 associated with a wide range of difficulties, including alcohol and drug problems 2 , poorer general health 3 , long-term unemployment 4 and reduced life expectancy 5 .”
From The influence of personality disorder on the future mental health and social adjustment of young adults: a population-based, longitudinal cohort study (2016) · cites this paper as [1]
Personality disorders as classified in DSM-IV affect about 6% of the world's population.
“PDs as currently classified in the DSM-IV system affects about 6 % of the world’s population [9, 11]”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [9]
Personality disorders have been associated with similar or higher societal costs than mood and anxiety disorders.
“Personality disorders (PDs) are now being accepted as important conditions in mainstream psychiatry and have been associated with similar or higher costs to society than mood and anxiety disorders [9–11]”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [9]
Personality disorders are relatively common in the community, and effective treatment is available for some.
“As PDs are relatively common in the community, and effective treatment is available for some, health care workers should be aware of the strong link between PDs and work force exclusion.”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [9]
Social functioning problems among people with personality disorder are clinically significant even after controlling for other comorbid mental health problems.
“problems in social functioning among people with personal ity disorder are clinically significant, even when the impact of other comorbid mental health problems has been con trolled for”
From Personality disorder: a new global perspective (2010) · cites this paper as [6]
The largest epidemiological study, across 10 countries including six low- or middle-income countries, shows personality disorders are no less prevalent outside Europe, North America and Australia.
“it demonstrates that personality disorders are no less prevalent outside Europe, North Amer ica and Australia”
From Personality disorder: a new global perspective (2010) · cites this paper as [6]
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- Authors
- Huang, Y., Kotov, R., de Girolamo, G., Preti, A., Angermeyer, M., Benjet, C., Demyttenaere, K., de Graaf, R., Gureje, O., Karam, A. N., Lee, S., Lépine, J. P., Matschinger, H., Posada-Villa, J., Suliman, S., Vilagut, G., & Kessler, R. C.
- Affiliations
- Peking University (CN)
- Stony Brook University (US)
- University of Cagliari (IT)
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz (MX)
- Universitair Ziekenhuis Leuven (BE)
- University College Hospital, Ibadan (NG)
- University of Balamand (LB)
- Chinese University of Hong Kong (HK)
- Leipzig University (DE)
- Stellenbosch University (ZA)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Harvard University (US)
- Corresponding author
- Kessler, Ronald C.
- ORCID
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2009-07
- Volume
- 195
- Issue
- 1
- Pages
- 46-53
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- PMC
- PMC2705873
- OpenAlex
- W2141371395
- Cited by
- 367
- References
- 57
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 10 · 2023: 53 · 2022: 14 · 2021: 71 · 2020: 30 · 2019: 20 · 2018: 19 · 2017: 19 · 2016: 21 · 2015: 14 · 2014: 19 · 2013: 17 · 2012: 15
- FWCI
- 15.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, other-oa)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Funders
- Robert Wood Johnson Foundation (044708, Grant 044708)
- John D. and Catherine T. MacArthur Foundation (R13-MH066849)
- John W. Alden Trust (R01-MH069864, R01-MH070884, R01-DA016558, R13-MH066849)
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- GlaxoSmithKline
- World Health Organization
- University of Michigan
- Università degli Studi di Cagliari
- European Commission (1999-01042, QLG5–1999-01042, SANCO2004123, 2004123)
- Institut National de la Santé et de la Recherche Médicale
- Generalitat de Catalunya (01042, RETICS RD06/0011 REM-TAP, CB06/02/0046)
- Bundesministerium für Gesundheit
- Centre National de la Recherche Scientifique
- Chinese University of Hong Kong
- Université Paris Diderot
- Peking University
- Regione Piemonte (00/0028)
- Stony Brook University
- National Institutes of Health (5r13mh066849-04, 5r01mh069864-04, 5r01mh070884-05)
- Substance Abuse and Mental Health Services Administration (044708)
- Pfizer Foundation (R01‐MH069864, R01-DA016558, R13-MH066849, R03-TW006481)
- Pan American Health Organization (FIRCA R03-TW006481)
- Medical Research Council
- Instituto de Salud Carlos III (CB06/02/0046, CIBER CB06/02/0046, RETICS RD06/0011 REM-TAP, RETICS RD06/0011 REM-TAP, RETICS RD06/0011, RD06/0011, FIS 00/0028, CIBER CB06/02/0046)
- Departament de Salut, Generalitat de Catalunya (CB06/02/0046, RETICS RD06/0011 REM-TAP)
- National Institute of Mental Health (R13-MH-066849, R01‐MH070884, R01-DA016558, U01-MH-60220, R01MH059575, MH60220, MH070884, MH069864, U13MH066849, MH066849, U01MH060220, R01‐MH069864)
- National Institute on Drug Abuse (K05DA015799, R01DA016558, U01-MH60220)
- Fogarty International Center (FIRCA R03TW006481, R03TW006481)
- Cilag
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- personality disorders, prevalence, cross-national comparison, International Personality Disorder Examination, Axis I comorbidity, role impairment, sociodemographic correlates, World Mental Health Surveys
- MeSH terms
- Age Factors, Cross-Cultural Comparison, Female, Health Surveys, Humans, Male, Personality Disorders, Risk Factors, Sex Factors, Socioeconomic Factors, Unemployment, World Health Organization, Prevalence, Cluster Analysis, Diagnostic and Statistical Manual of Mental Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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