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29 Epidemiology of DSM-Ill PDs were reported with structured interviews, 1.7% with the SIPDL2 and 2.2% with the SCID.'OAnother study" carried out at the ECA Baltimore site, ascertained the prevalence of compulsive PD in the community. and found a prevalence of 1.7%. Males had a rate about five times higher than females. The disorder was also more frequent among white, highly educated, married, and employed subjects, and it was associated with anxiety disorders. However, the study derived the diagnosis from an interview originally not intended to diagnose PDs. This could mean that they identified adaptive obsessive-compulsive traits rather than a PD. Using the PDQ, Zimmerman and C~ryell'~ found a low rate (0.4%), while Reich et al,15 in their study, which included only 235 subjects, found no cases. The rate was higher with an interview, suggesting that passive-aggressive persons may under-report on self-administered questionnaires. Epidemiological studies carried out in psychlatric settings Table 3 lists the main prevalence studies of PD carried out in in-patient and out-patient psychiatric samples. To summarize, although the prevalence of PD among psychiahic outpatients and in-patients can be high, both in patients with only a PD and in those with an Axis I disorder (especially affective disorders), no final wnclusion can be reached because the available sNdieS reported very different prevalence rates. The differences are probably due to differences in sampling, diagnostic criteria, assessment methods, availability of mental health services, prevalence of Axis I disorders, and sociocultural factors. Even when authors use ICD or DSM criteria, they may have done so in different ways. There are, however, some consistencies acmss studies. The most prevalent PD seems to be hoderline, both in in-patient and out-patient settings. The next most common FDs tend to be schiwtypal and histrionic. These three disorders are also characterized by the lowest social functioning. They are especially common in in-patient settings, as theirsymptomatology often results in hospitaliition due to suicidal hehavim, substance abuse, and cognitive-perceptual abnormalities. In out-patient settings, dependent and passive-aggressive PDs are also common. In a study carried out among 2344 patients attending a public psychiatric facility and having a DSM-111 diagnosis of PD, cluster B patients
Table 3. Prevalence rates ofpersonality disorders (PDs) nmongpsychiatricpatienls W o Author and year Country Sample size Classification Assessment %with Remarks of publication and setting system insmunenm PD (Ref. "0.) Allan. 1991 (43) UK LOO out-patients RDC Clinical 5 Alcohol abusers intreaunent inrerview ALnaes & Torgensen, Nonvay 298 out-patients DSM-III SIPD 81 97% had an Axis I diagnosis; about half 1988a (44.45) had an affective disorder Baer. cla1.. 1990(46) USA % out-patients DSM-I11 SIPD 52 Obsesdve-compulsivedisorden. Dependent and histrionic PDs wen the most cnnmon. Compulsive PD was found in only 6% of he samole. Berger, 1985 (35) Canada 486 out-patients DSM-III Clinical 39 assessment Castaneda & Fmlco, USA 1583in-patienm DSM-JU Clinical 6.4 1985 (47) assessment Chamey erol.. 1981 (48) USA IM)in-patients DSM-111 Clinical 61 assessment 14 23 Cutting ernl.. 1986 (49) UK LOO in-patients RDC SAP 44 Dowsongr Berries, UK 74 in- and DSM-UI-R PDQ-R - 1991 (50) wt-palients 4.5 Allpaients seen in aprivate psychiatric p~s~ticeover a period of five years Patients discharged from apsychiauic facility duxingone year; 101 received a primary diagnosis of PD 64 unipolar nonmelancholic depressives 66 unipolarmelpneholic depressives 30 bipolardepressives IOOconwcutive admissions with major psychiatric disorders. The pmponion of patienm with PD was comparable ammlg different diagnosic pups (depressives 54%. schiwphrcnics 3946. mania 39%) Each paient had aman numberof PD diarmoses. - Borderline (62%) . . and histrionic (61%) PDs were the most common.
Page 2 and 3: Until recently, the standardization
Page 4 and 5: Assessment and diagnosis of persona
Page 6 and 7: Contents Contributors Preface Annan
Page 8 and 9: Contributors Dr Antonio Andreoli Ho
Page 10 and 11: Preface One of the major goals of t
Page 12 and 13: ... Xlll Acknowledgements The IPDE
Page 14 and 15: Problems in the field of personalit
Page 16 and 17: 5 Problems in the field of PD perso
Page 18 and 19: 7 Problems in the field of PD In DS
Page 20 and 21: 9 Problems in the field of PD cultu
Page 22 and 23: 11 Review of diagnostic instruments
Page 30 and 31: 19 Epidemiology of DSM-Ill PDs in c
Page 32 and 33: Table l. Prevalence rates of specif
Page 35 and 36: 24 1. H. Reich and G. de Girolamo (
Page 37 and 38: 26 .- 5 2 0 W C .- 0 P g F ? g e Q
Page 39: 28 J. H. Reich and G. de Girolarno
Page 44 and 45: Pfohl etal.. l986 (67) Pilgrim & Ma
Page 46 and 47: 35 Epidemiology of DSM-Ill PDs were
Page 48 and 49: 37 Epidemiology of DSM-Ill PDs migh
Page 50 and 51: 39 Epidemiology of DSM-Ill PDs 23 R
Page 52 and 53: 4 1 Epidemiology of DSM-Ill PDs 55
Page 54 and 55: 43 International personality disord
Page 56 and 57: I 45 IPDE iner what he is actually
Page 58 and 59: 47 IPDE Sample of IPDE item The que
Page 60 and 61: 49 IPDE dimensional scores are not
Page 62 and 63: 1 9 IPDE considerable training and
Page 64 and 65: 53 Experiences with IPDE The invest
Page 66 and 67: 55 Experiences with IPDE passive ag
Page 68 and 69: 57 Field Trial
Page 70 and 71: 59 Sampling, inte~iewers, interview
Page 72 and 73: Description of centres participatin
Page 74 and 75: 63 Centres participating in IPDE fi
Page 82 and 83: P- P Table 1. Sample sizes and IPDE
Page 84 and 85: 73 Results Table 3. ICD-I0 Disorder
Page 86 and 87: 75 Results Table 5. Frequency of CO
Page 88 and 89: 77 Results Table 8. Interrater reli
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Discussion and conclusions Armand W
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8 1 Discussion and Conclusions stab
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83 Discussion and Conclusions Repet
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Discussion and Conclusions of princ
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87 Discussion and Conclusions Frequ
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89 Discussion and Conclusions emoti
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9 1 Discussion and Conclusions inte
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93 Appendix Table A2 Persomlity dis
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95 Appendix Table A4 Personality di
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97 Appendix Table A6 Personaliry di
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99 Appendix Table SA Personaliry di
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Table A10 Personality disorder diag
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103 Appendix Table A12 Personality
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Table A13 (con?) Criterion B7 B8 1
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107 Appendix Table A13 (cont) Frequ
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109 Appendix Table A14 (cont.) Freq
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Acknowledgements 113 Manual History
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Manual History of the IPDE One of t
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116 Manual Struchlre of the IPDE Th
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118 Manual that is likely to enhanc
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120 Manual data. If examiners have
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122 Manual Scoring conventions Much
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124 Manual Recording the scores Req
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126 Manual Q. What do you do when s
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128 Manual section, if there are qu
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ICD-10 criteria and corresponding I
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132 ICD-10 criteria and correspondi
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134 IPDE ICD-10 module screening qu
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136 Screening questionnaire 47 1 lo
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I 138 IPDE ICD-10 module* interview
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140 Interview schedule 2. 0 1 2 7 0
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142 Inte~iew schedule 4. O 1 2 I N
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144 Interview schedule 6. O l Z ? 0
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146 Interview schedule 8. 0 1 2 1 0
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148 Interview schedule .10. 0 1 2 ?
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150 Interview schedule 12. 0 1 2 7
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152 lnte~iew schedule 14. 0 1 2 ? 0
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154 Interview schedule 16. 0 1 2 ?
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156 interview schedule 18. 0 1 2 ?
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158 Interview schedule 20. O 1 2 N
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164 Interview schedule *26. 0 1 2 ?
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166 lntewiew schedule 28. 0 1 2 ? 0
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170 lnte~iew schedule 32. O 1 2 7 N
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174 lntewiew schedule 36. 0 1 2 ? 0
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176 lnterv~ew schedule 38. 0 1 2 ?
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184 lnte~iew schedule 46. 0 1 2 7 0
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~ 186 Interview schedule 48. 0 1 2
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194 Interview schedule 56. 0 1 2 1
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196 Interview schedule VI. IMPULSE
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200 Interview schedule Have you eve
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202 Interview schedule 1 63. 0 1 2
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204 Intewiew schedule Rate the foll
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206 IPDE ICD-10 module handscoring
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+ 39+44=4, 208 Handscoring algorith
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210 Handscoring algorithms and summ
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IPDE ICD-10 module summary scoreshe
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224 Index paranoid 108 schizoid 108
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226 Index Personalily Assessment Sc
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