A fresh e-mail news release from t...

A fresh e-mail news release from the American Academy of Family Physicians caught my attention. A landmark take a view of has reported the prevalence of personality disorders in the United States. According to the National Institute in succession Alcohol Abuse and Alcoholism, National Institutes of Health, the 2001-2002 National Epidemiologic contemplate on Alcohol and Related Conditions (NESARC) has shown that an estimated 149 percent of Americans 18 years or older (308 million persons) engage standard diagnostic criteria for at least single personality disorder, as defined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th ed (DSM-IV). The news release upon the survey is available online at http://www.niaaa.nih.gov/press/2004/landmark.htm.

The NESARC is a representative take a view of of noninstitutionalized U.S. civilians aged 18 years and older; more than 43000 American adults participated in the contemplate Designed to assess prevalence and comorbidity, or cooccurrence of multiple mental health disorders, the NESARC was the first national view conducted in the United States to estimate the prevalence of personality disorders. conclusions of the survey are reported in the Journal of Clinical Psychiatry (2004;65:948-58) and are available to subscribers at http://www.psychiatrist.com/.

Findings of the measure and estimate are significant: The most prevalent disorder in the United States is obsessive-compulsive personality disorder, which affects 79 percent of adults (representing approximately 164 million persons) Approximately 44 percent (92 million) have paranoid personality disorder; 36 percent (76 million) have antisocial personality disorder; 31 percent (65 million) have schizoid personality disorder; 24 percent (49 million) have avoidant personality disorder; 18 percent (38 million) have histrionic personality disorder; and 05 percent (10 million) have conditioned personality disorder.

The overlook found no gender differences in the prevalence of obsessive-compulsive, schizoid, or histrionic personality disorders. The prevalence of avoidant, contingent and paranoid personality disorders is greater in women than in men whereas the prevalence of antisocial personality disorder is greater in men than in women In general, other risk factors for personality disorders included being Native American or black, being a young adult, having depressed socioeconomic status, and being divorced, separated, widowed, or not at any time married. With the exception of histrionic personality disorder, all of the personality disorders assessed in the inspect were associated with considerable emotional disability and impairment in social and occupational functioning.

Given the significance of personality disorders in the general population, you may want to read the article in this issue onward the assessment and management of personality disorders, at Randy K. Ward, M.D. (see page 1505) Dr Ward notes that caring for patients with personality disorders can be problematic and frustrating, and oftentimes leads to dysfunctional physician-patient relationships that complicate the task of diagnosing and managing medical and psychiatric conditions. Physicians must prove to develop a working relationship with these patients to help them receive the best possible care despite their chronic difficulties in interacting with the health care system

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