The British Journal of Psychiatry (2009) 195: 46-53. doi: 10.1192/bjp.bp.108.058552
© 2009 The Royal College of Psychiatrists
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DSM–IV personality disorders in the WHO World Mental Health Surveys

Yueqin Huang, MD, MPH, PhD

Institute of Mental Health, Peking University, Beijing, China

Roman Kotov, PhD

Stony Brook University, Stony Brook, New York, USA

Giovanni de Girolamo, MD

IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy

Antonio Preti, MD

Department of Psychology, University of Cagliari, Italy

Matthias Angermeyer, PhD

Center for Public Mental Health, Gösing am Wagram, Austria

Corina Benjet, MD

National Institute of Psychiatry, Mexico City, Mexico

Koen Demyttenaere, PhD

University Hospital Gasthuisberg, Leuven, Belgium

Ron de Graaf, PhD

Netherlands Institute of Mental Health and Addiction, Utrecht, Netherlands

Oye Gureje, MD, PhD, FRCPsych

Department of Psychiatry, University College Hospital, Ibadan, Nigeria

Aimée Nasser Karam, PhD

Department of Psychiatry and Clinical Psychology, Saint George Hospital University Medical Center, Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University Medical School, and the Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon

Sing Lee, MBBS, FRCPsych

Department of Psychiatry, The Chinese University of Hong Kong, HKSAR, People’s Republic of China

Jean Pierre Lépine, MD

INSERM U 705, CNRS UMR 7157, University Paris Diderot, Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, France

Herbert Matschinger, PhD

Clinic of Psychiatry, University of Leipzig, Germany

José Posada-Villa, MD

Colegio Mayor de Cundinamarca University, Bogata, Colombia

Sharain Suliman, MA

MRC Anxiety Disorders Research Unit, Department of Psychiatry, University of Stellenbosch, South Africa

Gemma Vilagut, BSc

Health Services Research Unit, Institut Municipal d’Investigacio Medica (IMIM), CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain

Ronald C. Kessler, PhD

Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA

Correspondence: Ronald C. Kessler, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, Massachusetts 02115, USA. Email: kessler{at}hcp.med.harvard.edu

Declaration of interest

R.C.K has been a consultant for GlaxoSmithKline, Kaiser Permanente, Pfizer Inc, Sanofi-Aventis, Shire Pharmaceuticals and Wyeth-Ayerst. He has served on advisory boards for Eli Lilly & Company and Wyeth-Ayerst, and has had research support for his epidemiological studies from Bristol-Myers Squibb, Eli Lilly & Company, GlaxoSmithKline, Johnson & Johnson Pharmaceuticals, Ortho-McNeil Pharmaceuticals Inc, Pfizer Inc and Sanofi-Aventis.

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.