Prevalence, correlates, disability, and comorbidity of DSM-IV narcissistic personality disorder: results from the wave 2 national epidemiologic survey on alcohol and related conditions.
OBJECTIVE
To present nationally representative findings on prevalence, sociodemographic correlates, disability, and comorbidity of narcissistic personality disorder (NPD) among men and women.


METHODS
Face-to-face interviews with 34,653 adults participating in the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions conducted between 2004 and 2005 in the United States.


RESULTS
Prevalence of lifetime NPD was 6.2%, with rates greater for men (7.7%) than for women (4.8%). NPD was significantly more prevalent among black men and women and Hispanic women, younger adults, and separated/divorced/widowed and never married adults. NPD was associated with mental disability among men but not women. High co-occurrence rates of substance use, mood, and anxiety disorders and other personality disorders were observed. With additional comorbidity controlled for, associations with bipolar I disorder, post-traumatic stress disorder, and schizotypal and borderline personality disorders remained significant, but weakened, among men and women. Similar associations were observed between NPD and specific phobia, generalized anxiety disorder, and bipolar II disorder among women and between NPD and alcohol abuse, alcohol dependence, drug dependence, and histrionic and obsessive-compulsive personality disorders among men. Dysthymic disorder was significantly and negatively associated with NPD.


CONCLUSIONS
NPD is a prevalent personality disorder in the general U.S. population and is associated with considerable disability among men, whose rates exceed those of women. NPD may not be as stable as previously recognized or described in the DSM-IV. The results highlight the need for further research from numerous perspectives to identify the unique and common genetic and environmental factors underlying the disorder-specific associations with NPD observed in this study.
Stinson
Frederick S
FS
Laboratory of Epidemiology and Biometry, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-9304, USA.
Dawson
Deborah A
DA
Goldstein
Risë B
RB
Chou
S Patricia
SP
Huang
Boji
B
Smith
Sharon M
SM
Ruan
W June
WJ
Pulay
Attila J
AJ
Saha
Tulshi D
TD
Pickering
Roger P
RP
Grant
Bridget F
BF
D000069:Acculturation; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D000437:Alcoholism / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D044383:Black People / Q000706:statistics & numerical data; D015897:Comorbidity; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004185:Disability Evaluation; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D009289:Narcissism; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D012649:Self Concept; D012720:Severity of Illness Index; D017678:Sex Distribution; D012928:Social Desirability; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data