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Themenschwerpunkt

Epidemiologie und Verlauf von Persönlichkeitsstörungen

Published Online:March 21, 2018https://doi.org/10.1024/1661-4747/a000344

Abstract

Zusammenfassung. Repräsentative Erhebungen zu Persönlichkeitsstörungen in den vergangenen Jahrzehnten haben unser epidemiologisches Wissen über die Verteilung und den Verlauf über Persönlichkeitsstörungen beträchtlich verbessert. So finden sich in unterschiedlichen Studien etwa 6 bis 10 Prozent Personen beiderlei Geschlechts mit Persönlichkeitsstörungen, wobei die Häufigkeiten in Abhängigkeit von soziodemographischen Daten schwanken. Höhere Angaben finden sich beispielsweise bei geschiedenen Paaren oder bei Personen mit geringeren Schulabschlüssen. Auffällig weiter sind Zusammenhänge mit psychischen Störungen und Auffälligkeiten wie Substanzmissbrauch oder Alkoholabhängigkeit sowie einem auffällig niedrigem sozialem Funktionsniveau. Was den Verlauf der Persönlichkeitsstörungen angeht, lässt sich heute jedoch feststellen, dass sie sich heute angesichts zunehmend besserer Psychotherapiekonzepte recht erfolgreich behandeln lassen. Dies gilt insbesondere für die Behandlung von Borderline-Persönlichkeitsstörungen. Dennoch sind zukünftig prospektive Verlaufsstudien notwendig, um Risikofaktoren und Konsequenzen in ihrer Vielfalt besser einschätzen zu können.


Epidemiology and course of personality disorders

Abstract. Community studies conducted over the past decade have greatly increased our knowledge of the epidemiology of personality disorders. Here, we review the prevalence, distribution, and consequences of personality disorders, and potential risk factors for their development. An estimated 6–10% of individuals in the community have a personality disorder. The prevalence of personality disorders varies across sociodemographic groups, being higher, for example, in those who are separated or divorced and those who have dropped out of high school. Personality disorders are often associated with Axis I disorders in the community, including alcohol and other substance use disorders, as well as with functional impairment. As far as the course of personality disorders is concerned, it can be seen today that they can now be treated successfully in the face of progressively better psychotherapy concepts. This is especially true for the treatment of Borderline personality disorders. Nevertheless additional prospective studies are needed to elucidate potential precursors and consequences of personality disorders in their diversity.

Literatur

  • Abrams, R. C. & Horowitz, S. V. (1996). Personality disorders after age 50: A meta-analysis. Journal of Personality Disorders, 10, 271–281. First citation in articleCrossref, Google Scholar

  • APA – American Psychiatric Association(1987). Diagnostic and statistical manual of mental disorders (3rd ed.; revised). Washington, DC: American Psychiatric Association. [deutsch (1989). Diagnostisches und Statistisches Manual Psychischer Störungen DSM-III-R. Weinheim: Beltz]. First citation in articleGoogle Scholar

  • APA – American Psychiatric Association(1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association [deutsch (1996). Diagnostisches und Statistisches Manual Psychischer Störungen DSM-IV. Göttingen: Hogrefe]. First citation in articleGoogle Scholar

  • APA – American Psychiatric Association(2000). Diagnostic and statistical manual of mental disorders – DSM-IV-TR (4th ed.; Text Revision). Washington, DC: American Psychiatric Association. [deutsch: (2003). Diagnostisches und Statistisches Manual Psychischer Störungen – Textrevision – DSM-IV-TR. Göttingen: Hogrefe]. First citation in articleGoogle Scholar

  • APA – American Psychiatric Association(2013). Diagnostic and statistical manual of mental disorders – DSM-5 (5th ed.). Washington, DC: American Psychiatric Association [deutsch (2015). Diagnostisches und Statistisches Manual Psychischer Störungen DSM-5. Göttingen: Hogrefe]. First citation in articleCrossref, Google Scholar

  • Fiedler, P. (2007). Persönlichkeitsstörungen (6. Aufl.). Weinheim: Beltz-PVU. First citation in articleGoogle Scholar

  • Fiedler, P. & Herpertz, S.C. (2016). Persönlichkeitsstörungen (7. Aufl.). Weinheim: Beltz. First citation in articleGoogle Scholar

  • Galione, J. N. & Oltmanns, T.F. (2013). The relationship between borderline personality disorder and major depression in later life: acute versus temperamental symptoms. American Journal of Geriatric Psychiatry, 21, 747–756. First citation in articleCrossref, Google Scholar

  • Girolamo, G. de & Reich, J. H. (1993). Personality disorders. Genf: World Health Organization Publications. [Epidemiology of Mental Health Disorders and Psychosocial Problems]. First citation in articleGoogle Scholar

  • Grilo, C. M., Sanislow, C. A., Gunderson, J. G.et al.(2004). Two-year stability and change of schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders. Journal of Consulting and Clinical Psychology, 72, 767–775. First citation in articleCrossref, Google Scholar

  • Grilo, C. M., McGlashan, T. H. & Skodol, A. E. (2014). Course and outcome. In J., M. OldhamA., E. SkodolD., S. Bender (Eds.), Textbook of personality disorders (2nd ed.; pp. 165–186). Washington, DC: The American Psychiatric Publishing, Inc. First citation in articleGoogle Scholar

  • Gunderson, J. G., Shea, M. T., Skodol, A. E.et al.(2000). The Collaborative Longitudinal Personality Disorders Study, I: development, aims, designs and sample characteristics. Journal of Personality Disorders, 14, 300–315. First citation in articleCrossref, Google Scholar

  • Gunderson, J. G., Stout, R. L., McGlashan, T. H., Shea, M. T., Morey, L. C., Grilo, C. M., Zanarini, M. C., Yen, S., Markowitz, J. C., Sanislow, C., Ansell, E., Pinto, A. & Skodol, A. E. (2011). Ten-year course of borderline personality disorder: psychopathology and functioning from the Collaborative Longitudinal Personality Disorders Study. Archives of General Psychiatry, 68, 827–837. First citation in articleCrossref, Google Scholar

  • Johnson, J. G., Cohen, P., Kasen, S.et al.(2008). Cumulative prevalence of personality disorders between adolescence and adulthood. Acta Psychiatrica Scandinavia, 118, 410–413. First citation in articleCrossref, Google Scholar

  • Klein, D. N., Riso, L. P., Donaldson, S. K., Schwartz, J. E., Anderson, R. L., Ouimette, P. C., … Aronson, T. A. (1995). Family study of early onset dysthymia: mood and personality disorders in relatives of outpatients with dysthymia and episodic major depressive and normal controls. Archives of General Psychiatry, 52, 487–496. First citation in articleCrossref, Google Scholar

  • Lenzenweger, M. F., Lane, M. C., Loranger, A. W. & Kessler, R. C. (2007). DSM-IV personality disorders in the national comorbidity survey replication. Biological Psychiatry, 62, 553–564. First citation in articleCrossref, Google Scholar

  • Lindal, E. & Stefansson, J. G. (2009). The prevalence of personality disorders in the greater-Reykjavik area. Laeknabladid, 95, 179–184. First citation in articleGoogle Scholar

  • Loranger, A. W., Sartorius, N., Andreoli, A., Berger, P., Buchheim, P., Channabasavana, S. M., … Regier, D. A. (1994). The International Personality Disorder Examination: IPDE. The WHO/ADAMHA international pilot study of personality disorders. Archives of General Psychiatry, 51, 215–224. First citation in articleCrossref, Google Scholar

  • Maier, W., Lichtermann, D., Klinger, T., Heun, R. & Hallmayer, J. (1992). Prevalences of personality disorders (DSM-III-R) in the community. Journal of Personality Disorders, 6, 187–196. First citation in articleCrossref, Google Scholar

  • Millon, T. & Grossman, S. D. (2005). Sociocultural factors. In J., M. OldhamA., E. SkodolD., S. Bender (Eds.), Textbook of personality disorders (pp. 223–235). Washington, DC: The American Psychiatric Publishing, Inc. First citation in articleGoogle Scholar

  • Morey, L. C. & Meyer, J.K. (2012). Course of personality disorders. In T., A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 275–298). Oxford University Press. First citation in articleGoogle Scholar

  • Oldham, J. M. & Skodol, A. E. (2013). Personality and personality disorders and the passage of time. American Journal of Geriatric Psychiatry, 21, 709–712. First citation in articleCrossref, Google Scholar

  • Paris, J. & Zweig-Frank, H. (2001). A twenty-seven year follow-up of borderline patients. Comprehensive Psychiatry, 42, 482–487. First citation in articleCrossref, Google Scholar

  • Roberts, B. W. & DelVecchio, W. F. (2000). The rank-order consistency of personality traits from childhood to old age; a quantitative review of longitudinal studies. Psychological Bulletin, 126, 3–25. First citation in articleCrossref, Google Scholar

  • Ross, T., Malanin, A. & Pfäfflin, F. (2004). Stressbelastung, Persönlichkeitsstörungen und Migration. Verhaltenstherapie und Verhaltensmedizin, 25, 345–366. First citation in articleGoogle Scholar

  • Samuels, J., Eaton, W. W., Bienvenu, O. J., Brown, C. H., Costa, P. T. & Nestadt, G. (2002). Prevalence and correlates of personality disorders in a community sample. British Journal of Psychiatry, 180, 536–542. First citation in articleCrossref, Google Scholar

  • Schuster, J. P., Hoertel, N., LeStrat, Y., Manetti, A., Limosin, F. (2013). Personality disorders in older adults: findings from the national epidemiologic survey on alcohol and related conditions. American Journal of Geriatric Psychiatry, 21, 757–768. First citation in articleCrossref, Google Scholar

  • Segal, D. L., Hersen, M., van Hasselt, V. B., Silberman, C. S. & Roth, L. (1996). Diagnosis and assessment of personality disorders in older adults: A critical review. Journal of Personality Disorders, 10, 384–399. First citation in articleCrossref, Google Scholar

  • Seivewright, H., Tyrer, P. & Johnson, T. (2002). Change in personality status in neurotic disorders. Lancet, 359, 2253–2254. First citation in articleCrossref, Google Scholar

  • Shea, M. T., Stout, R., Gunderson, J., Morey, L. C., Grilo, C. M., McGlashan, T., … Keller, M. B. (2002). Short-term diagnostic stability of schizotypal, borderline, avoidant, or obsessive-compulsive personality disorders. American Journal of Psychiatry, 159, 2036–2041. First citation in articleCrossref, Google Scholar

  • Skodol, A. E., Gunderson, J. G., Shea, M. T., McGlashan, T. H., Morey, L. C., Sanislow, C. A., … Stout, R. L. (2005). The Collaborative Longitudinal Personality Disorders Study (CLPS): overview and implications. Journal of Personality Disorders, 19, 487–504. First citation in articleCrossref, Google Scholar

  • Stevenson, J., Meares, R. & Comerford, A. (2003). Diminished impulsivity in older patients with borderline personality disorder. American Journal of Psychiatry, 160, 165–166. First citation in articleCrossref, Google Scholar

  • Torgersen, S., Kringlen, E. & Cramer, V. (2001). The prevalence of personality disorders in a community sample. Archives of General Psychiatry, 58, 590–596. First citation in articleCrossref, Google Scholar

  • Torgersen, S. (2012). Epidemiology. In T., A. Widiger (Ed.), The Oxford handbook of personality disorders (pp. 186–205). Oxford: Oxford University Press. First citation in articleGoogle Scholar

  • Torgersen, S. (2014). Prevalence, sociodemographics, and functional impairment. In J., M. OldhamA., E. SkodolD., S. Bender (Eds.), Textbook of personality disorders (2nd ed.; pp. 109–129). Washington, DC: The American Psychiatric Publishing, Inc. First citation in articleGoogle Scholar

  • WHO – Weltgesundheitsorganisation(1991/1993). Internationale Klassifikation psychischer Störungen. ICD-10 Kapitel V (F). Klinisch-diagnostische Leitlinien (1./2. Aufl.; Hrsg.: H. Dilling, W.Mombour, M. H. Schmidt & E., Schulte-Markwort). Bern: Huber. First citation in articleGoogle Scholar

  • Zanarini, M. C., Frankenburg, F. R., Hennen, J., Silk, K. R. (2003). The longitudinal course of borderline psychopathology: 6-year prospective follow-up of the phenomenology of borderline personality disorder. American Journal of Psychiatry,160, 274–283. First citation in articleCrossref, Google Scholar

  • Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B. & Silk, K. R. (2005). Psychosocial functioning of borderline patients and Axis II comparison subjects followed prospectively for six years. Journal of Personality Disorders, 19, 19–29. First citation in articleCrossref, Google Scholar

  • Zanarini, M. C., Frankenburg, F. R., Hennen, J., Reich, D. B. & Silk, K. R. (2006). Prediction of the 10-years course of borderline personality disorder. American Journal of Psychiatry, 163, 827–832. First citation in articleCrossref, Google Scholar

  • Zanarini, M. C., Frankenburg, F. R., Reich, D. B. & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients borderline personality disorder and axis II comparison subjects: a 16-year prospective follow-up study. American Journal of Psychiatry, 169, 476–483. First citation in articleCrossref, Google Scholar

  • Zimmerman, M. & Coryell, W. (1989). DSM-III personality disorder diagnosis in a nonpatient sample. Archives of General Psychiatry, 46, 682–689. First citation in articleCrossref, Google Scholar