Personality disorders: a burden in the community, neglected in the clinic?

aDepartments of Psychiatry, University of Arizona College of Medicine, Tucson, Arizona, and the Columbia University College of Physicians and Surgeons, New York, New York *Corresponding author: Andrew E. Skodol, MD, 2626 E Arizona Biltmore Cir, Unit #29, Phoenix, AZ 85016 ([email protected]). J Clin Psychiatry 2015;76(11):e1482–e1484 dx.doi.org/10.4088/JCP.14com09597 © Copyright 2015 Physicians Postgraduate Press, Inc. I this issue of the Journal, the article “Reductions in Quality of Life Associated With Common Mental Disorders: Results From a Nationally Representative Sample” by Penner-Goeke and colleagues1 examines losses in quality of life (QoL) years associated with common mental and physical disorders in the large (US) sample of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The authors were especially interested in assessing the impact of personality disorders on QoL, since personality disorders have rarely been studied in comparison to other disorders in community populations. The NESARC Wave 2 sample is very large (N = 34,533), thus enabling examination of the impact of many variables on QoL simultaneously. All 10 DSM-IV personality disorders were diagnosed, as well as a wide range of other mental and physical disorders, and impact on QoL was examined at both individual and population levels. Penner-Goeke and colleagues1 found that mood disorders were associated with the greatest decreases in health-related QoL, followed by stroke, psychotic disorders, and arthritis. Due to the relative prevalence of the various disorders, however, the greatest annual QoL losses were caused by arthritis, mood disorders, and personality disorders at a population level.