title: Personality disorders: epidemiology and public health issues.
abstract: Community studies conducted over the past decade have greatly increased our knowledge of the epidemiology of personality disorders. Here, we review the prevalence, distribution, and consequences of personality disorders, and potential risk factors for their development. An estimated 6-10% of individuals in the community have a personality disorder. The prevalence of personality disorders varies across sociodemographic groups, being higher, for example, in those who are separated or divorced and those who have dropped out of high school. Personality disorders are strongly associated with Axis I disorders in the community, including mood disorders, anxiety disorders, and alcohol and other substance use disorders, as well as with functional impairment. Personality disorders also are associated with medical service use and medical morbidity and mortality, especially related to cardiovascular disease. Individuals in the community with personality disorders are more likely to have a history of criminal arrest, interpersonal violence, and suicidal behaviours. Childhood adversities, especially abuse and neglect, are potential risk factors for the development of personality disorders. Additional prospective studies are needed to elucidate potential precursors and consequences of personality disorders. Furthermore, primary and secondary prevention strategies are needed to reduce the individual and societal burdens from personality disorders in the community.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. jacks@jhmi.edu
authors.forename: Jack
authors.initials: J
authors.lastname: Samuels
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D015897:Comorbidity; D006801:Humans; D008605:Mental Health Services; D019964:Mood Disorders / Q000453:epidemiology / Q000523:psychology; D010554:Personality Disorders / Q000453:epidemiology* / Q000523:psychology*; D011634:Public Health; D012307:Risk Factors; D012931:Social Environment; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology