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Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis

  • Jana Volkert (a1), Thorsten-Christian Gablonski (a2) and Sven Rabung (a3)



Personality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous rates.


We aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity.


We searched PsycINFO, PSYNDEX and Medline for studies that used standardised diagnostics (DSM-IV/-5, ICD-10) to report prevalence rates of personality disorders in community populations in Western countries. Prevalence rates were extracted and aggregated by random-effects models. Meta-regression and sensitivity analyses were performed and publication bias was assessed.


The final sample comprised ten studies, with a total of 113 998 individuals. Prevalence rates were fairly high for any personality disorder (12.16%; 95% CI, 8.01–17.02%) and similarly high for DSM Clusters A, B and C, between 5.53 (95% CI, 3.20–8.43%) and 7.23% (95% CI, 2.37–14.42%). Prevalence was highest for obsessive–compulsive personality disorder (4.32%; 95% CI, 2.16–7.16%) and lowest for dependent personality disorder (0.78%; 95% CI, 0.37–1.32%). A low prevalence was significantly associated with expert-rated assessment (versus self-rated) and reporting of descriptive statistics for antisocial personality disorder.


Epidemiological studies on personality disorders in community samples are rare, whereas prevalence rates are fairly high and vary substantially depending on samples and methods. Future studies investigating the epidemiology of personality disorders based on the DSM-5 and ICD-11 and models of personality functioning and traits are needed, and efficient treatment should be a priority for healthcare systems to reduce disease burden.

Declaration of interest



Corresponding author

Correspondence: Dr Jana Volkert, Department of Psychosocial Prevention, University of Heidelberg, Bergheimer Str. 54, 69115 Heidelberg, Germany. Email


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1American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. American Psychiatric Association, 2013.
2Fok, ML-Y, Hayes, RD, Chang, C-K, Stewart, R, Callard, FJ, Moran, P. Life expectancy at birth and all-cause mortality among people with personality disorder. J Psychosom Res 2012; 73(2): 104–7.
3Skodol, AE. Personality pathology and population health. Lancet Psychiatry 2016; 3(7): 595–6.
4Moran, P, Romaniuk, H, Coffey, C, Chanen, A, Degenhardt, L, Borschmann, R, et al. The influence of personality disorder on the future mental health and social adjustment of young adults: a population-based, longitudinal cohort study. Lancet Psychiatry 2016; 3(7): 636–45.
5Grant, BF, Chou, SP, Goldstein, RB, Huang, B, Stinson, FS, Saha, TD, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline personality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008; 69(4): 533–45.
6Frankenburg, FR, Zanarini, MC. The association between borderline personality disorder and chronic medical illnesses, poor health-related lifestyle choices, and costly forms of health care utilization. J Clin Psychiatry 2004; 65(12): 1660–5.
7Hiroeh, U, Appleby, L, Mortensen, PB, Dunn, G. Death by homicide, suicide, and other unnatural causes in people with mental illness: a population-based study. Lancet 2001; 358(9299): 2110–2.
8Oldham, JM. Borderline personality disorder and suicidality. Am J Psychiatry 2006; 163(1): 20–6.
9Tyrer, P, Reed, GM, Crawford, MJ. Classification, assessment, prevalence, and effect of personality disorder. Lancet 2015; 385(9969): 717–26.
10Barrett, B, Byford, S. Costs and outcomes of an intervention programme for offenders with personality disorders. Br J Psychiatry 2012; 200(4): 336–41.
11Wagner, T, Roepke, S, Marschall, P, Stiglmayr, C, Renneberg, B, Gieb, D, et al. Krankheitskosten der Borderline Persönlichkeitsstörung aus gesellschaftlicher Perspektive. Z Klin Psychol Psychother 2013; 42(4): 242–55.
12Torgersen, S, Kringlen, E, Cramer, V. The prevalence of personality disorders in a community sample. Arch Gen Psychiatry 2001; 58(6): 590–6.
13Weissman, MM. The epidemiology of personality disorders: a 1990 update. J Pers Disord 1993; 7: 4462.
14Coid, J, Yang, M, Tyrer, P, Roberts, A, Ullrich, S. Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 2006; 188: 423–31.
15Huang, Y, Kotov, R, de Girolamo, G, Preti, A, Angermeyer, M, Benjet, C, et al. DSM-IV personality disorders in the WHO World Mental Health Surveys. Br J Psychiatry 2009; 195(1): 4653.
16Bach, B, Maples-Keller, JL, Bo, S, Simonsen, E. The alternative DSM-5 personality disorder traits criterion: a comparative examination of three self-report forms in a Danish population. Personal Disord 2016; 7(2): 124–35.
17World Health Organization. The ICD-10 Classification of Mental and Behavioural Disorders. Clinical Descriptions and Diagnostic Guidelines. World Health Organization, 1992.
18American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. American Psychiatric Press, 2000.
19Wells, GA, Shea, B, O'Connell, D, Peterson, J, Welch, V, Losos, M, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Nonrandomised Studies in Meta-Analyses. Health Research Institute, 2004.
20Rotenstein, LS, Ramos, MA, Torre, M, Segal, JB, Peluso, MJ, Guille, C, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA 2016; 316(21): 2214–36.
21Barendregt, JJ, Doi, SA, Lee, YY, Norman, RE, Vos, T. Meta-analysis of prevalence. J Epidemiol Community Health 2013; 67(11): 974–8.
22Cooper, H, Hedges, LV, Valentine, JC. The Handbook of Research Synthesis and Meta-Analysis. Russell Sage Foundation, 2009.
23Lipsey, MW, Wilson, DB. Practical Meta-Analysis. Sage Publishing, 2000.
24Egger, M, Davey Smith, G, Schneider, M, Minder, C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315(7109): 629–34.
25Sterne, JA, Egger, M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol 2001; 54(10): 1046–55.
26Schwarzer, G. meta: An R package for meta-analysis. R News 2007; 7(3): 40–5.
27Loranger, AW, Sartorius, N, Andreoli, A, Berger, P, Buchheim, P, Channabasavanna, SM, et al. The international personality disorder examination. The World Health Organization/alcohol, drug abuse, and Mental Health Administration international pilot study of personality disorders. Arch Gen Psychiatry 1994; 51(3): 215–24.
28First, MB, Gibbon, M, Spitzer, RL. Structured Clinical Interview for DSM-IV Axis II Personality Disorders. American Psychiatric Press, 1997.
29Grant, BF, Dawson, DA, Hasin, DS. The Alcohol Use Disorders and Associated Disabilities Interview Schedule DSM-IV Version. National Institute on Alcohol Abuse and Alcoholism, 2001.
30Ottosson, H, Bodlund, O, Ekselius, L, Knorring, L, Kullgren, G, Lindström, E, et al. The DSM-IV and ICD-10 Personality Questionnaire (DIP-Q): construction and preliminary validation. Nord J Psychiatry 1995; 49(4): 285–92.
31Dereboy, C, Güzel, HS, Dereboy, F, Okyay, P, Eskin, M. Personality disorders in a community sample in Turkey: prevalence, associated risk factors, temperament and character dimensions. Int J Soc Psychiatry 2014; 60(2): 139–47.
32Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2016 (GBD 2016) Incidence, Prevalence, and Years Lived with Disability 1990-2016. Institute for Health Metrics and Evaluation, 2017.
33Beckwith, H, Moran, PF, Reilly, J. Personality disorder prevalence in psychiatric outpatients: a systematic literature review. Personal Ment Health 2014; 8(2): 91101.
34Fazel, S, Danesh, J. Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys. Lancet 2002; 359(9306): 545–50.
35Tyrer, P, Coombs, N, Ibrahimi, F, Mathilakath, A, Bajaj, P, Ranger, M, et al. Critical developments in the assessment of personality disorder. Br J Psychiatry Suppl 2007; 49: s51–9.
36Insel, T, Cuthbert, B, Garvey, M, Heinssen, R, Pine, DS, Quinn, K, et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 2010; 167(7): 748–51.
37Newton-Howes, G, Clark, LA, Chanen, A. Personality disorder across the life course. Lancet 2015; 385(9969): 727–34.
38Bach, B, Sellbom, M, Kongerslev, M, Simonsen, E, Krueger, RF, Mulder, R. Deriving ICD-11 personality disorder domains from dsm-5 traits: initial attempt to harmonize two diagnostic systems. Acta Psychiatr Scand 2017; 136(1): 108–17.
39Sharp, C, Wright, AGC, Fowler, JC, Frueh, BC, Allen, JG, Oldham, J, et al. The structure of personality pathology: both general (‘g’) and specific (‘s’) factors? J Abnorm Psychol 2015; 124(2): 387–98.
40Tyrer, P, Crawford, M, Sanatinia, R, Tyrer, H, Cooper, S, Muller-Pollard, C, et al. Preliminary studies of the ICD-11 classification of personality disorder in practice. Personal Ment Health 2014; 8(4): 254–63.


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Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis

  • Jana Volkert (a1), Thorsten-Christian Gablonski (a2) and Sven Rabung (a3)
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