There has been limited research on the prevalence of personality disorders in the aged. No studies have documented the extent of personality disorders in community-dwelling elderly with the use of a structured scale specifically designed to detect personality disorders and anchored to DSM-III-R criteria. One hundred male and 100 female community-living elderly (mean age, 72.1 years) were administered the Structured Interview for Disorders of Personality-Revised to compare prevalence rates for specific personality disorders with those of young adults (mean age, 41.7 years) and to identify demographic variables associated with personality disorders in the elderly. Results indicate a tendency toward fewer personality disorders in older than young adults, no differences in the frequency of personality disorders between male and female elderly, and significantly more prior mental health consultations in elderly with personality disorders than in elderly without these disorders. Aging processes and methodologic issues that could accountfor differences in personality disorder distribution between young and older adults are discussed. Recommendations for future research are outlined.
Get full access to this article
View all access options for this article.
References
1.
1. American Psychiatric Association, Committee on Nonmenclature and Statistics.Diagnostic and statistical manual of mental disorders, 3rd Ed.Washington, DC: American Psychiatric Association, 1980.
2.
2. Hyler S, Rieder R, Williams J, et al. The personality diagnostic questionnaire: development and preliminary results. J Pers Disord1988; 2:229–237.
3.
3. Spitzer R, Williams J, Gibbons M, First M.Structured Clinical Interview for DSM-III Personality Disorders (SCID-II). New York: New York State Psychiatric Institute, Biometrics Research, 1985.
4.
4. Loranger A, Susman V, Oldham J, Russakoff LM. The personality disorder examination: a preliminary report. J Pers Disord1987; 1:1–13.
5.
5. Zanarini MM, Frankenburg FR, Chauncey DL, Gunderson JG. The diagnostic interview for personality disorders: interrater and test-retest reliability. Compr Psychiatry1987; 28:467–480.
7. Stangl D, Pfohl B, Zimmerman M, et al. A structured interview for the DSM-III personality disorders. Arch Gen Psychiatry1985; 42:591–596.
8.
8. Nunn C, Bergmann K, Britton PG, et al. Intelligence and neurosis in old age. Br J Psychiatry1974; 124:446–452.
9.
9. Simon A.The neuroses, personality disorders, alcoholism, drug use and misuse, and crime in the aged. In: Birren J, Sloane RB, Eds. Handbook of mental health and aging. Englewood Cliffs, NJ: Prentice-Hall, 1980: 653–670.
10.
10. Kroessler D.Personality disorders in the elderly. Hosp Community Psychiatry1990; 41:1325–1329.
11.
11. Casey P.The epidemiology of personality disorder. In: Tyrer P, ed. Personality disorders; diagnosis, management, and course. London: John Wright, 1988: 74–81.
12.
12. Merikangas K, Weissman M.Epidemiology of DSM-III axis II personality disorders. In: American Psychiatric Association annual review. Washington, DC: American Psychiatric Press, 1986: 258–278.
14. Wiggins JS, Pincus A.Conceptions of personality disorders and dimensions of personality. Psychol Assess J Consult Clin Psychol1989; 1:305–316.
15.
15. McCrae R, Costa P.Personality in adulthood. New York: Guilford Press, 1990.
16.
16. Verwoerdt A.Clinical geropsychiatry. Baltimore: Williams & Wilkins, 1976: 85–88.
17.
17. Solomon K.Personality disorders and the elderly. In: Lion J, ed. Personality disorders: diagnosis and management. Baltimore: Williams & Wilkins, 1978: 310–328.
18.
18. Gurland B.Personality disorders of old age. In: Kay D, Burrows G, Eds. Handbook of studies on psychiatry and old age. New York: Elsevier, 1984: 303–318.
19.
19. Straker M.Adjustment disorders and personality disorders in the aged. Psychiatr Clin North Am1982; 5:121–129.
20.
20. Sadavoy J, Fogel B.Personality disorders in old age. In: Birren J, Sloane RB, Cohen G, Eds. Handbook of mental health and aging. San Diego: Academic Press, 1992: 433–462.
21.
21. Tyrer P, Seivewright H.Studies of outcome. In: Tyrer P, ed. Personality disorders: diagnosis management and course. London: John Wright, 1988: 119–136.
22.
22. Robins L, Helzer J, Weissman M, et al. Lifetime prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry1984; 41:949–959.
23.
23. Gutmann DL. Female ego styles and generational conflict. In: Bardwick JM, Douvan E, Horner MS, Gutmann D, Eds. Feminine personality and conflict. Belmont, CA: Brooks/Cole, 1970: 77–96.
24.
24. Gynther M.Aging and personality. In: Butcher J, ed. New developments in the use of the MMPI. Minneapolis: University of Minneapolis Press, 1979: 39–58.
25.
25. Lawton M, Whelihan W, Belsky J.Personality tests and their uses with older adults. In: Birren J, Sloane RB, Eds. Handbook of mental health and aging. Englewood Cliffs; NJ: Prentice-Hall, 1980: 537–553.
26.
26. Weiss J.The natural history of antisocial attitudes: What happens to psychopaths. J Geriatr Psychiatry1973; 6:236–242.
27.
27. Bernal G, Brannon L, Belar C, et al. Psychodiagnostics of the elderly. In: Gentry WD, ed. Geropsychology: a model of training and clinical service. Cambridge, MA: Ballinger, 1977: 43–77.
28.
28. Hyer L, Harrison WR. Late life personality model: diagnosis and treatment. In: Brink TL, ed. Clinical gerontology: a guide to assessment and treatment. New York: Haworth Press, 1986: 399–415.
29.
29. Kroll J, Sines L, Martin K, et al. Borderline personality disorder: construct validity of the concept. Arch Gen Psychiatry1981; 38:1021–1026.
30.
30. Kroll J, Carey K, Sines L, Roth M.Are there borderlines in Britain?Arch Gen Psychiatry1982; 39:60–63.
31.
31. Reich J.Sex distribution of DSM-III personality disorders in psychiatric outpatients. Am J Psychiatry1987; 4:485–488.
32.
32. Zimmerman M, Coryell W.DSM-III personality disorder diagnoses in a nonpatient sample. Arch Gen Psychiatry1989; 46:682–689.
33.
33. Brink TL. Geriatric psychotherapy. New York: Human Sciences Press, 1979.
34.
34. Zimmerman M, Coryell W.The reliability of personality disorder diagnoses in a nonpatient sample. J Pers Disord1989; 3:53–57.
35.
35. Pfohl B, Stangl D, Zimmerman M.The implications of DSM-III disorders for patients with major depression. J Affective Disord1984; 7:309–318.
37. Casey PR, Dillon S, Tyrer C.The diagnostic status of patients with conspicuous psychiatric morbidity in primary care. Psychol Med1984; 14:673–681.
38.
38. Perry JC, Vaillant GE. Personality disorders. In: Kaplan H, Sadock B, Eds. Comprehensive textbook of psychiatry. Baltimore: Williams & Wilkins, 1989: 1352–1378.
39.
39. Zimmerman M, Pfohl B, Stangl D, Corenthal C.The assessment of DSM-III personality disorders: the importance of interviewing an informant. J Clin Psychiatry1986; 47:261–263.
40.
40. Shea MT, Glass D, Pilkonis P, et al. Frequency and implications of personality disorder in a sample of depressed outpatients. J Pers Disord1987; 1:27–42.
41.
41. Zimmerman M, Coryell W, Pfohl B, et al. ECT responses in depressed patients with and without a DSM-III personality disorder. Am J Psychiatry1986; 143:1030–1032.
42.
42. Reich J.DSM-III personality disorders and the outcome of treated panic disorders. Am J Psychiatry1988; 45:1149–1152.
43.
43. Thompson L, Gallagher D, Czirr R.Personality disorders and outcome in the treatment of late-life depression. J Geriatr Psychiatry1988; 21:133–146.
