Landmark Survey Reports on the Prevalence of Personality Disorders in the United States
An estimated 30.8 million American adults (14.8 percent) meet standard
diagnostic criteria for at least one personality disorder as defined
in the American Psychiatric Associations Diagnostic and Statistical
Manual of Mental Disorders-Fourth Edition (DSM-IV), according
to the results of the 2001-2002 National Epidemiologic Survey on
Alcohol and Related Conditions (NESARC) reported in the current
issue of the Journal of Clinical Psychiatry [Volume 65:948-958].
Conducted by the National Institute on Alcohol Abuse and Alcoholism,
National Institutes of Health, the NESARC is a representative survey
of the U.S. civilian noninstitutionalized population aged 18 years
and older. More than 43,000 American adults participated in the
survey. Designed to assess prevalence and comorbidity, or co-occurrence,
of multiple mental health disorders, the NESARC is the first national
survey conducted in the United States to estimate the prevalence
of selected personality disorders stable patterns of inner experience
and behavior that are inflexible and maladaptive that begin in early
adulthood and are displayed in a variety of contexts that often
co-occur with other mental health disorders such as substance use
disorders and anxiety and mood disorders.
The NESARC found that the personality disorders are pervasive in
the general population: In 2001- 2002, fully 16.4 million individuals
(7.9 percent of all adults) had obsessive-compulsive personality
disorder; 9.2 million (4.4 percent) had paranoid personality disorder;
7.6 million (3.6 percent) had antisocial personality disorder; 6.5
million (3.1 percent) had schizoid personality disorder; 4.9 million
(2.4 percent) had avoidant personality disorder; 3.8 million (1.8
percent) had histrionic personality disorder; and 1.0 million (0.5
percent) had dependent personality disorder.
The researchers found that risk of having avoidant, dependent,
and paranoid personality disorders is greater for females than males,
whereas risk of having antisocial personality disorder is greater
for males than females. They found no gender differences in the
risk of having obsessive-compulsive, schizoid, or histrionic personality
disorders. In general, other risk factors for personality disorders
included being Native American or Black, being a young adult, having
low socioeconomic status, and being divorced, separated, widowed,
or never married. With the exception of histrionic personality disorder,
all the personality disorders assessed in the survey were associated
with considerable emotional disability and impairment in social
and occupational functioning.
The first-time availability of prevalence information on
personality disorders at the national level is critically important,
said Dr. Ting-Kai Li, M.D., Director, National Institute on Alcohol
Abuse and Alcoholism. Personality disorders consistently have
been associated with substantial impairment and decreased psychological
functioning among alcohol and drug abusers.
The NESARC was crucial in determining the scope of personality
disorders confronting the nation and in identifying important subgroups
of the population in greatest need of prevention efforts,
said lead author Bridget F. Grant, Ph.D., Ph.D., Chief, Laboratory
of Epidemiology and Biometry, Division of Intramural Clinical and
Biological Research, NIAAA. In a separate paper, the authors report
findings on the prevalence and co-occurrence of alcohol, drug, mood,
and anxiety disorders; the study appears in the current Archives
of General Psychiatry [Volume 61, August 2004].
Full text of the Journal of Clinical Psychiatry article
is available to media representatives from the NIAAA Press Office
and to journal subscribers at www.psychiatrist.com.
For interviews with Dr. Grant, please call the NIAAA Press Office.
The National Institute on Alcohol Abuse and Alcoholism, a component
of the National Institutes of Health, U.S. Department of Health
and Human Services, conducts and supports approximately 90 percent
of the U.S. research on the causes, consequences, prevention, and
treatment of alcohol abuse, alcoholism, and alcohol problems and
disseminates research findings to science, practitioner, policy
making, and general audiences. Additional alcohol research information
and publications are available at www.niaaa.nih.gov.