The prevalence of personality disorders in the community: a global systematic review and meta-analysis
AuthorWinsper, C; Bilgin, A; Thompson, A; Marwaha, S; Chanen, AM; Singh, SP; Wang, A; Furtado, V
Source TitleBritish Journal of Psychiatry
PublisherCAMBRIDGE UNIV PRESS
University of Melbourne Author/sThompson, Andrew
AffiliationCentre for Youth Mental Health
Document TypeJournal Article
CitationsWinsper, C., Bilgin, A., Thompson, A., Marwaha, S., Chanen, A. M., Singh, S. P., Wang, A. & Furtado, V. (2020). The prevalence of personality disorders in the community: a global systematic review and meta-analysis. BRITISH JOURNAL OF PSYCHIATRY, 216 (2), pp.69-78. https://doi.org/10.1192/bjp.2019.166.
Access StatusAccess this item via the Open Access location
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-income countries and low- and middle-income countries (LMICs). METHOD: We systematically searched PsycINFO, MEDLINE, EMBASE and PubMed from January 1980 to May 2018 to identify articles reporting personality disorder prevalence rates in community populations (PROSPERO registration number: CRD42017065094). RESULTS: A total of 46 studies (from 21 different countries spanning 6 continents) satisfied inclusion criteria. The worldwide pooled prevalence of any personality disorder was 7.8% (95% CI 6.1-9.5). Rates were greater in high-income countries (9.6%, 95% CI 7.9-11.3%) compared with LMICs (4.3%, 95% CI 2.6-6.1%). In univariate meta-regressions, significant heterogeneity was partly attributable to study design (two-stage v. one-stage assessment), county income (high-income countries v. LMICs) and interview administration (clinician v. 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% (95% CI 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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