Table
1: Research
evidence on the treatment of APD. Prevalence and comorbidity.
Article |
Kind of study |
Sample |
Result |
Limits |
APD without SP* |
Skodol et al. [6] |
Clinical based,
epidemiological study, follow up of 2 years |
600 patients with PD
or MDD and no PD followed for at period of to years. APD n = 137. |
Symptoms of PD remain
stable over time, APD patients had better outcome regarding employment
function but a worse result regarding social relationships, but not social
functioning. |
Positive association
bias in assessing relationship quality (< % of PD was in a relationship at
the beginning of the study). Limited follow up
period for testing changes in PD. |
Yes |
Zimmerman et al. [12] |
Community based,
epidemiological study |
859 Psychiatric
outpatients |
1/3 of the enrolled
patients had a PD. APD had the higher %
of being diagnosed as a single PD (58.7%) along with the HPD (66.7%) APD had also high OR
of comorbid PD with cluster A and cluster B PD APD had a significant
association with a diagnosis of MDD, GAD and Panic Disorder (~ 20 - 25% of
co-diagnosis) |
The study was
conducted in a private practice group that does not target patients without a
health insurance and lower-income patients. No follow-up. |
Yes |
Asarnow et al. [14] |
Community and clinical
based epidemiological study |
Probands of childhood onset schizophrenia (n
= 148), relatives of ADHD patients (n = 368) and community controls (n = 206) |
Risk of APD was
higher in COS probands (9.41%) vs. controls (1.67%) |
Large confidential
intervals are reported |
No |
Reichborn-Kjennerud et al. [15] |
Population based
epidemiological study |
Adult female-female
twin pairs. 1427 pairs (898 monozygotic and 529 dizygotic) were included in
the analysis and had valid data |
The prevalence of APD
was 2.7%. 32.5% of subjects
with APD also had PD 30.6% of subjects
with generalized social phobia also had APD 18.3% of subjects
with PD also had APD |
Based on females
twins only |
Yes |
Cox et al. [16] |
Epidemiological
investigation based on a previous survey on Alcohol and Related Conditions |
34905 individuals
representing the general population in 50 United States |
Lifetime
prevalence of APD = 2.4% Lifetime prevalence
of SP = 2.8% 36.4% of individuals
with SP had also APD |
The survey was not
initially focused on personality disorders |
Yes |
Tillfors et al. [17] |
Epidemiologically
identified probands of individuals with SP |
1000 women and 1000
men randomly sampled in the greated Stockholm area |
A 2 to 3 fold
increased RR of social anxiety as a function of a positive parental history
of SP or APD, alone or in combination Familial aggregation
of SP was not modulated by other diagnoses in axis I or II, indicating that
SP and AVP may not be separated disorders |
Diagnosis was made
through a self-questionnaire |
Yes |
Lampe et al. [18] |
10641 individuals
enrolled in the Australian National Survey of Mental health and Well Being |
APD 12 month
prevalence = 1.5% 28.9% of individuals
with SP also had APD. |
Non
specific for APD |
No |
|
Lampe et al. [19] |
Epidemiological study
on the general population |
381 individuals
enrolled in the Australian National Survey of Mental health and Well Being |
APD 12 month
prevalence = 2.3%; F:M ratio = 1.5 26% of subjects with
SP also had ADP; F:M ratio = 2 |
Small sample size |
Yes |
Hummelen et al. [20] |
Epidemiological study
involving 12 units of the Norwegian network of Psychotherapeutic Day
Hospitals |
2192 individuals
enrolled in the study |
39 % had APD, 48% of
whom also had SP |
The units that
contributed to the enrollment are specialized in personality disorders, this
could create a selection bias or over diagnosis of the disorders when
compared to the general population. |
Yes |
Torgersen et al. [98] |
Epidemiological study
in the general population |
2053 individuals from
the general population |
5% of the population
had APD |
/ |
No |
Grant et al. [99] |
Epidemiological study
in the general population |
43093 respondents in
the National Institute on Alcohol Abuse and Acloholism's
2001-2002 National Epidemiologic Survey on Alchol
and Related Conditions |
2.4% of the
population had APD |
Non
specific for APD |
No |