Personality disorders and physical comorbidities in adults from the United States: data from the National Epidemiologic Survey on Alcohol and Related Conditions

Soc Psychiatry Psychiatr Epidemiol. 2015 May;50(5):807-20. doi: 10.1007/s00127-014-0974-1. Epub 2014 Oct 15.

Abstract

Purpose: There is a paucity of research examining the relationship between personality disorders (PDs) and chronic physical comorbidities. Consequently, we investigated associations between individual PDs and PD Clusters, and various common disease groups [cardiovascular disease (CVD), diabetes, arthritis and gastrointestinal disease (GI)] in a nationally representative survey of adults from the United States.

Methods: This study utilized pooled data (n = 34,653; ≥20 years) from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. PDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Physical conditions were based on self-reports of being diagnosed by a health professional. Unadjusted and adjusted logistic regressions examined the relationship between PDs and physical conditions.

Results: After adjustment (sociodemographic factors, past-year mood, anxiety and substance use disorders), Clusters A, B and C PDs were each associated with physical conditions (all p ≤ 0.01). Of the individual PDs, schizoid, schizotypal, narcissistic, borderline and obsessive-compulsive PDs were associated with CVD (all p ≤ 0.01) among younger adults. Paranoid, antisocial, borderline and avoidant PDs and younger adults with schizoid, schizotypal and obsessive-compulsive PDs were each associated with arthritis (all p ≤ 0.01). Significant associations were seen between paranoid, schizoid and schizotypal PDs and diabetes (all p ≤ 0.01). Finally, schizotypal, antisocial, borderline and narcissistic PDs were associated with GI conditions (all p ≤ 0.01).

Conclusions: PDs were consistently associated with physical conditions. Investigation of PDs and their relationship with physical health outcomes warrant further research attention as these findings have important clinical implications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohols
  • Anxiety Disorders / epidemiology
  • Arthritis / epidemiology*
  • Cardiovascular Diseases / epidemiology*
  • Comorbidity
  • Diabetes Mellitus / epidemiology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Gastrointestinal Diseases / epidemiology*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Personality Disorders / epidemiology*
  • Physical Examination
  • Self Report
  • Substance-Related Disorders / epidemiology
  • United States
  • Young Adult

Substances

  • Alcohols