Part of: Mental Health and Illness

Related to: Anxiety and Depression, Eating Disorders,Self-Harm, Suicide and Mortality of Undetermined Intent, People with Multiple Needs, Safe Places in Health-based Settings Guardianship under the 1983 Mental Health ActWellbeing, Emotional Health and Wellbeing of Children and Young People, Safeguarding Adults, Safeguarding Children and Young People, Alcohol and Mental Health , Substance Misuse, Domestic Abuse, Education Absence and Exclusion

Key Facts

  • Studies estimate that personality disorders affect 4-11% of the UK population.
  • Between 60-70% of the UK prison population have a personality disorder.
  • The directly age standardised rate of personality disorders in the Bath and North East Somerset GP registered population is 36 per 10,000 (691 cases).
  • In B&NES the directly age standardised rate of personality disorders is higher for men (40.2 per 10,000) than for women (32 per 10,000).
  • It is estimated that in 2012, 0.82% (1,083 people) of the 16-74 year old population B&NES had a obsessive compulsive disorder.

Definition  1 2

Personality disorders are a group of conditions characterised by an inability to get on with other people and learn from experience. They are a long-standing and maladaptive pattern of perceiving and responding to other people and to stressful circumstances. Thus, a personality disorder is defined as an enduring pattern of inner experience and behaviour that differs markedly from the expectations of the individual's culture, is pervasive and inflexible. Personality disorders usually involve several areas of the personality and are nearly always associated with considerable personal and social disruption.

People with a personality disorder may find that their beliefs and attitudes are different from those of most other people. Others may find their behaviour unusual, unexpected or perhaps offensive.

Personality disorders usually become apparent in adolescence or early adulthood, although they can start in childhood. They affect how a person thinks and behaves, making it hard for them to live a normal life. People diagnosed with personality disorder may be very inflexible – they may have a narrow range of attitudes, behaviours and coping mechanisms which they are not able to change easily, if at all.

People with personality disorders may find it difficult to: make or keep relationships, get on with people at work, get on with friends and family, keep out of trouble and control their feelings or behaviour. As a result, many may feel hurt, distressed, alienated and alone.

Causes 3 

The cause of personality disorders remains obscure. Traditional belief is that these behaviours result from a dysfunctional early environment that prevents the evolution of adaptive patterns of perception, response and defence.

Factors in childhood which are postulated to be linked to personality disorder include:

  • Sexual abuse
  • Physical abuse
  • Emotional abuse
  • Neglect
  • Being bullied

Emotional or behavioural factors that might play a part include:

  • Truanting
  • Bullying others
  • Being expelled/suspended
  • Running away from home
  • Deliberate self-harm
  • Prolonged periods of misery

Also, the evidence base supporting a link between personality disorder and genetic factors is growing.

Types 4

There are ten personality disorders that are divided into three clusters, designated A, B, C.

Cluster A: Suspicious - paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder

Cluster B: Emotional and impulsive - anti-social personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder

Cluster C: Anxious - avoidant personality disorder, dependent personality disorder and obsessive compulsive personality disorder

What does the data say?

UK 5 

Studies estimate that personality disorders affect 4-11% of the UK population. Many of the features we can possibly recognise in ourselves or others but, often, several features are required to make a diagnosis

Between 60-70% of the prison population have a personality disorder. This is so common as to be almost a variation of normal rather than pathological. In the prison population there are probably comparatively few who do not have at least one of personality disorder, mental illness, learning difficulties and substance abuse.

Gender 6 

Antisocial personality disorder - is three times more frequent in men than in women.

Borderline personality disorder - is three times as common in women as in men.

Narcissistic personality disorder - Men account for 50% to 75% of those with narcissistic personality disorder.

Links with other mental health conditions 7 

When diagnosed, between 30 and 50% of patients with schizotypal personality disorder already have major depression and most have a history of at least one major depressive episode.

Bath and North East Somerset

The directly age standardised rate of personality disorders in the B&NES GP registered population is 36 per 10,000 (691 cases):

  • That is 32 per 10,000 for females and 40.2 per 10,000 for males.
  • Rates in different GP practices vary considerably with St Michaels being the highest at 93 per 10,000 and Bath University being the lowest at 2 per 10,000. In total, 7 practices have significantly lower results than the B&NES average and 4 have significantly higher results8
  • Results show that the age specific rates of personality disorders in B&NES increase with age to a peak at age 45-54 for men (approximately 79 per 10,000 men) and 65-74 for women (65 per 10,000 women). Rates are higher for men until approximately age 75 when they are higher for women.

Obsessive compulsive disorder - It is estimated that in 2012, 0.82% (1,083 people) of the 16-74 year old population Bath and North East Somerset had a obsessive compulsive disorder, slightly lower than the rate in the South West (0.83%) and England (1.10%). It is predicted that these rates will remain stable into 2021, with estimates indicating 0.81% of 16-74 year olds in B&NES will have a obsessive compulsive disorder, 0.82% in the South West and 1.14% in England. 9