DSM-IV personality disorders in the WHO World Mental Health Surveys

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=21162) 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.