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. 2021 Dec 24:12:800047.
doi: 10.3389/fpsyt.2021.800047. eCollection 2021.

Prevalence of Comorbid Personality Disorder in Psychotic and Non-psychotic Disorders

Qiang Wang  1   2 , Lei Zhang  2 , Jiechun Zhang  2 , Zhihao Ye  2 , Ping Li  2 , Feng Wang  2 , Yili Cao  2 , Shaojun Zhang  2 , Fang Zhou  2 , Zisheng Ai  1 , Nan Zhao  2
Affiliations

Prevalence of Comorbid Personality Disorder in Psychotic and Non-psychotic Disorders

Qiang Wang et al. Front Psychiatry. .

Abstract

Introduction: The burden of personality disorders (PDs) in China is large and the focus on mental health services is increasing. However, there is a lack of sufficient evidence regarding the prevalence of comorbid PD in psychotic and non-psychotic disorders, and whether PDs have different distributions. We aimed to investigate the PD comorbidity distribution pattern between psychotic and non-psychotic disorders using a clinical population-based study. Materials and Methods: We conducted a cross-sectional study of 1,497 patients in Shanghai. PDs were screened using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+). All patients were interviewed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) Axis II (SCID-II). We compared the differences in PD comorbidities classified as the 10 types of PDs in the DSM-IV, in 531 patients with psychosis and 966 patients with non-psychotic disorders. Results: More than one-third (37%) of patients with psychotic disorders met the criteria of at least one PD. Approximately half (46%) of patients with non-psychotic disorders met the criteria of at least one PD. Patients with non-psychotic disorders were more likely to meet the criteria of borderline (χ2 = 20.154, p < 0.001) and obsessive-compulsive PD (χ2 = 21.164, p < 0.001) diagnoses compared to those with psychotic disorders. In contrast, patients with psychotic disorders were more likely to meet the criteria of paranoid (χ2 = 11.144, p = 0.001) and schizotypal PD (χ2 = 14.004, p < 0.001) diagnoses than those with non-psychotic disorders. Discussion: PD comorbidity is common and comorbidity distribution pattern is varied in patients with psychotic and non-psychotic disorders, implicating the development of specific strategies that could screen and assess PDs in psychiatric clinical practice.

Keywords: comorbidity; non-psychotic disorders; personality disorder; prevalence; psychiatric disorders.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of the fourth plus version of Personality Diagnostic Questionnaire (PDQ-4+) self-reported personality disorders (PDs) among patients with psychotic and non-psychotic disorders.
Figure 2
Figure 2
Prevalence of the structured clinical interview for DSM-IV Axis-II (SCID-II)-diagnosed personality disorders (PDs) among patients with psychotic and non-psychotic disorders.
Figure 3
Figure 3
Comorbid PDs among patients with psychotic and non-psychotic disorders.
See this image and copyright information in PMC

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