<h4>Background</h4>Personality disorder is a severe health issue. However, the epidemiology of personality disorders is insufficiently described and surveys report very heterogeneous rates.AimsWe aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity.<h4>Method</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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 interestNone. Review Prevalence of personality disorders in the general adult population in Western countries: systematic review and meta-analysis Jana Volkert, Thorsten-Christian Gablonski and Sven Rabung Background Personality disorder is a severe health issue. However, the epi- demiology of personality disorders is insufficiently described and surveys report very heterogeneous rates. Aims We aimed to conduct a meta-analysis on the prevalence of personality disorders in adult populations and examine potential moderators that affect heterogeneity. 12– 14 These differences may be attributable to the use of different study populations, sam- pling methods and diagnostic assessment. However, establishing reliable epidemiological data can enable adequate planning of mental healthcare provision. So far, no meta-analysis on the prevalence of personality disor- ders exists. Accordingly, the primary aim of this study was to assess the prevalence rates of personality disorders in the general adult population in Western countries. The secondary aim was to examine potential moderator variables that may affect heterogeneity in prevalence rates. A random-effects model was chosen as this model addresses hetero- geneity between studies and study populations, and is more robust in case of large variations in sample size. 22 The magnitude of heterogeneity was assessed by the I2 index.23 Reported confidence intervals reflect a 95% criterion. To examine potential sources of bias, meta-regression analyses were conducted for each personality disorder individually, for Clusters A, B and C, and for any personality disorder. We investigated the effect of potentially distorting risk of bias criteria. For Cluster B personality disorders, we found rates between 0.83% for histrionic personality disorder (95% CI, 0.36 – 1.48, I 2 = 96.50%, Q = 170.45, P< 0.0001) and 3.05% for antisocial personality disorder (95% CI, 2.10 – 4.16, I2 = 98.30%, Q = 356.98, P< 0.0001). The overall random-effects esti- mate for BPD was 1.90% (95% CI, 0.85 – 3.34%, I2 = 99.10%, Q = 875.03, P< 0.0001), and Furthermore, study 9 and study 7 were most frequently associated with the largest variations in prevalence estimates compared with the other studies: study 9 was associated with the largest decreases in prevalence for 11 out of 15 personality disorder diagnoses (schizotypal, paranoid, any Cluster A, BPD, histrionic, antisocial, narcissistic, any Cluster B, dependent, obsessive – compulsive and any Cluster C), with the largest changes for any Cluster A (−2.03%), any Cluster B ( −1.81%) and any Cluster C personality disorders (−1.77%). Discussion Our aim was to estimate the prevalence of personality disorders in the general adult population in Western countries and to examine potential moderating factors. Overall personality disorders have been investigated in only very few epidemiological studies com- pared with other mental disorders. The low number of available epi- demiological studies may be because the diagnosis of personality disorders is more complex and resource intensive. An assessment based on a dimensional approach, 39 which regards personality func- tioning and traits to be present in healthy and clinical populations with varying degree of severity and interlinks personality pathology with the five-factor model, appears promising. In the ICD-11, indi- vidual categories of personality disorders will disappear. Increase of prevalence rates may be one implication as the diagnosis can then be made at any time of life. 4 Moran 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. 5 Grant BF, Chou SP, Goldstein RB, Huang B, Stinson FS, Saha TD, et al. Prevalence, correlates, disability, and comorbidity of DSM-IV borderline per- sonality disorder: results from the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008; 69(4): 533– 45. 6 Frankenburg FR, Zanarini MC.

The aim of this systematic review and meta-analysis was to investigate the diagnostic, the dimensional mean-level, and rank-order stability of personality disorders (PDs) and PD criteria over time. EMBASE, PsycInfo, PubMed, and Web of Science were searched for peer-reviewed studies published in either English, German, or French between the first publication of the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 and December 20, 2022. Inclusion criteria were a prospective longitudinal study design, assessing the stability of PDs or PD criteria over at least two measurement occasions at least one month apart, and using the same assessment at baseline and follow-up. Effect sizes included proportion of enduring cases (i.e., diagnostic stability), test-retest correlations (i.e., dimensional rank-order stability), and within-group standardized mean differences (i.e., dimensional mean-level stability), based on the first and last available measurement occasion. From an initial pool of 1473 studies, 40 were included in our analyses, covering 38,432 participants. 56.7% maintained the diagnosis of any PD, and 45.2% maintained the diagnosis of borderline PD over time. Findings on the dimensional mean-level stability indicate that most PD criteria significantly decreased from baseline to follow-up, except for antisocial, obsessive-compulsive, and schizoid PD criteria. Findings on the dimensional rank-order stability suggested moderate estimates, except for antisocial PD criteria, which were found to be high. Findings indicated that both PDs and PD criteria were only moderately stable, although between study heterogeneity was high, and stability itself depended on several methodological factors.

Personality disorder is a persistent and pervasive mental disorder, defined as an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of an individual's culture, but it remains under-recognised in global mental health estimates. To our knowledge, no comprehensive synthesis has quantified the global prevalence, mortality, or diagnostic stability of personality disorder using population-representative data. We aimed to address these gaps to support future burden of disease modelling. We conducted a systematic review and meta-regression of population-based surveys following PRISMA and GATHER guidelines. Eligible studies were cross-sectional or longitudinal studies published in peer-reviewed journals that reported prevalence or mortality associated with any personality disorder using DSM or ICD diagnostic criteria on representative samples. Personality disorder encompassed paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive-compulsive, and other specified and unspecified personality disorders. Studies using self-report instruments and non-representative samples (eg, clinical, incarcerated, or university populations) were excluded. Studies were identified through systematic searches in PubMed, Embase, and PsycINFO from Jan 1, 1980, to Feb 13, 2024. Studies were reviewed (by JS and a research assistant), and eligible data were extracted by JS. All data were non-identifiable and pre-aggregated from existing sources. Study quality was assessed using Joanna Briggs Institute critical appraisal tools. Due to data availability, we did two separate meta-regression analyses to estimate the prevalence and standardised mortality ratios associated with personality disorder, and a descriptive analysis to examine diagnostic stability. Between-study heterogeneity was assessed using the I2 statistic. Meta-regression models assessed the effect of study-level covariates. Members of ou We aimed to address these gaps to support future burden of disease modelling. Methods We conducted a systematic review and meta-regression of population-based surveys following PRISMA and GATHER guidelines. Eligible studies were cross-sectional or longitudinal studies published in peer-reviewed journals that reported prevalence or mortality associated with any personality disorder using DSM or ICD diagnostic criteria on representative samples. Personality disorder encompassed paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive-compulsive, and other specified and unspecified personality disorders. To our knowledge, no comprehensive synthesis has quantified the global prevalence, mortality, or diagnostic stability of personality disorder using population-representative data. We aimed to address these gaps to support future burden of disease modelling. Methods We conducted a systematic review and meta-regression of population-based surveys following PRISMA and GATHER guidelines. Eligible studies were cross-sectional or longitudinal studies published in peer-reviewed journals that reported prevalence or mortality associated with any personality disorder using DSM or ICD diagnostic criteria on representative samples. Personality disorder encompassed paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive-compulsive, and other specified and unspecified personality disorders. Studies using self-report instruments and non-representative samples (eg, clinical, incarcerated, or university populations) were excluded. Studies were identified through systematic searches in PubMed, Embase, and PsycINFO from Jan 1, 1980, to Feb 13, 2024. Studies were reviewed (by JS and a research assistant), and eligible data were extracted by JS. All data were non-identifiable and pre-aggregated from existing sources. AU - Chanen, Andrew PY - 2025/12 Y1 - 2025/12 N2 - Background Personality disorder is a persistent and pervasive mental disorder, defined as an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of an individual's culture, but it remains under-recognised in global mental health estimates. To our knowledge, no comprehensive synthesis has quantified the global prevalence, mortality, or diagnostic stability of personality disorder using population-representative data. We aimed to address these gaps to support future burden of disease modelling. Methods We conducted a systematic review and meta-regression of population-based surveys following PRISMA and GATHER guidelines. Eligible studies were cross-sectional or longitudinal studies published in peer-reviewed journals that reported prevalence or mortality associated with any personality disorder using DSM or ICD diagnostic criteria on representative samples. Personality disorder encompassed paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive-compulsive, and other specified and unspecified personality disorders. We provide a comprehensive synthesis of personality disorder epidemiology, offering the foundation needed to inform future global estimates and policy responses. AB - Background Personality disorder is a We aimed to address these gaps to support future burden of disease modelling. Methods We conducted a systematic review and meta-regression of population-based surveys following PRISMA and GATHER guidelines. Eligible studies were cross-sectional or longitudinal studies published in peer-reviewed journals that reported prevalence or mortality associated with any personality disorder using DSM or ICD diagnostic criteria on representative samples. Personality disorder encompassed paranoid, schizoid, schizotypal, antisocial, borderline, histrionic, narcissistic, avoidant, dependent, obsessive-compulsive, and other specified and unspecified personality disorders.

Reviews the literature on some of the issues that have been proposed as controversial with the diagnosis of Narcissistic Personality Disorder. Discusses the issues of comorbidity that questions the validity of the diagnosis; dimensional models of classification and what constitutes a narcissistic personality disorder; and the role that culture plays in the diagnosis. (Contains 92 references.) (Author/GCP)

This article aims to discuss worldwide trends in the prevalence of narcissistic personality disorder (NPD) among prisoners compared to community samples. We also aim to show how this disorder is associated with criminal behavior and types of offenses. The results of the literature review document a relatively low and stable prevalence of narcissistic personality disorder compared to the frequency of other specified personality disorders in many countries worldwide. The results suggest that the rates of narcissistic personality disorder among prisoners in many countries are higher than those in communities. It has been found that this disorder is associated with domestic violence and other violent criminal behaviors, particularly with fraud and forgery violations. It has also been shown that offenders with narcissistic personality disorder are perceived as less guilty. Furthermore, research on the treatment of offenders with narcissistic personality disorder is sparse, which indicates that the treatment of NPD is limited, and it poses a challenge for mental health professionals as well as those who work in the penitentiary system.

Narcissistic personality disorder (NPD) is considered a very complex mental health disorder influenced by different genetic, neurobiological, and environmental factors. Neurobiologically, abnormalities in brain regions within the prefrontal cortex and limbic system contribute to difficulties in emotional regulation and empathy. The environmental factor easily predisposing them to it comes in the form of childhood trauma or over-spoiling by parents. NPD is often comorbid with other personality disorders, such as borderline personality disorder and antisocial personality disorder, which makes the diagnosis even more complex. The treatments of NPD include psychodynamic therapy, in particular, transference-focused psychotherapy, cognitive-behavior techniques such as schema therapy, and the newest, which includes mentalization-based treatment. There also is the enormous challenge of engaging patients with NPD in therapy, given the typical features of resistance, such as grandiosity and ignorance of the true self. Because of this, future research on NPD, especially early intervention and elaboration, has become the expected and focused direction.

Narcissistic Personality Disorder (NPD) is a complex and enduring psychiatric condition characterized by persistent patterns of grandiosity, excessive need for admiration, and marked deficits in empathy. While narcissistic traits exist on a continuum in the general population, pathological narcissism results in significant functional impairment across interpersonal, occupational, and emotional domains. This paper provides a comprehensive review of NPD from both historical and contemporary perspectives. It traces the disorder’s psychoanalytic origins in the works of Freud, Kernberg, and Kohut,

Objective : The present study examined, from a transdiagnostic perspective, the potential association between personality traits and psychopathological symptoms and eating disorders (EDs). Method : A sample of adults aged over 18 years was recruited through social media and clinical settings (N = 83; mean age = 30 years; 78% women). Of these participants, 16 reported having been diagnosed with an eating disorder, whereas 67 reported no such diagnosis. All participants completed several instruments assessing temperament variables, perfectionism, narcissistic personality disorder traits, muscle

Mental health literacy (MHL) refers to lay people’s knowledge and beliefs about the diagnosis and treatment of mental illness. The current study aimed at investigating MHL regarding personality disorders (PDs) multiculturally, comparing Turkish and Italian populations. In total, 262 participants responded to an online vignette identification task that required them to label the PDs of seven hypothetical subjects and rate various dimensions of their disorders. Narcissistic (25%), obsessive-compulsive (13%), and paranoid (12%) PDs were the most correctly labeled, while the average accuracy value