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Article   |    
Personality Disorders Diagnosed at Intake at a Public Psychiatric Facility
Horacio Fabrega, Jr.; Richard Ulrich; Paul Pilkonis; Juan Mezzich
Psychiatric Services 1993; doi:
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University of Pittsburgh School of Medicine and the Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, Pennsylvania 15213

1993 by the American Psychiatric Association

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Objective: The purpose of the study was to determine the prevalence of personality disorders among a large population of persons seeking treatment in a public psychiatric facility ad to examine the role of personality disorders in the clinical conditions of persons frequenting such facilities. Methods: Clinical and demographic data were retrospectively examined for 18,179 adults who visited a walk-in clinic of a public psychiatric facility between 1983 and 1989. Patients who received a diagnosis of personality disorder were compared with those who did not. Results: A total of 2,344 patients (12.9 percent) were diagnosed as having a personality disorder, a lower prevalence rate than generally found in treatment populations. The most frequent diagnoses were atypical, antisocial, and borderline personality disorders. Compared with other subjects, those with a personality disorder were significantly more likely to be men, to be 35 years old or younger, to have a higher level of social impairment, and to have more symptoms and more severe symptoms. Conclusions: The relatively low prevalence rate was attributed in part to underdiagnosis, largely due to the need for making rapid assessments in a public intake setting. The authors conclude that clinicians in such facilities may be likely to diagnose personality disorders when patients with certain axis I disorders such as substance use, affective, ad adjustment disorders present with an overall greater level of symptomatology ad social impairment.

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