Prevalence and correlates of personality disorder in Great Britain

Background Epidemiological data on personality disorders, comorbidity and associated use of services are essential for health service policy. Aims To measure the prevalence and correlates of personality disorder in a representative community sample. Method The Structured Clinical Interview for DSM - IV Axis 11 disorders was used to measure personality disorder in 626 persons aged 16-74 years in households in England, Scotland and Wales, in a two-phase survey Results The weighted prevalence of personality disorder was 4.4% (95% Cl 2.9-6.7). Rates were highest among men, separated and unemployed participants in urban locations. High use of healthcare services was confounded by comorbid mental disorder and substance misuse. Cluster B disorders were associated with early institutional care and criminality. Conclusions Personality disorder is common in the community especially in urban areas. Services are normally restricted to symptomatic, help-seeking individuals, but a vulnerable group with cluster B disorders can be identified early, are in care during childhood and enter the criminal justice system when young. This suggests the need for preventive interventions at the public mental health level. Declaration of interest P.T. is editor of the British Journal of Psychiatry but had no part in the evaluation of this paper for publication.