Personality disorders in homeless drop-in center clients

Sixty homeless clients at two drop-in centers in different boroughs in New York City were assessed using the Structured Clinical Interview for DSM-IV Axis I and II disorders and the Positive and Negative Syndrome Scale. Very high rates of all personality disorders were found for Cluster A (73% paranoid, 65% schizoid, 43% schizotypal), B (57% antisocial, 62% borderline, 20% histrionic, 57% narcissistic) and C (50% avoidant, 25% dependent, 57% obsessive compulsive). Axis I mood, anxiety, and substance use disorders were each diagnosed in over half the sample. At least one Cluster A disorder was diagnosed in 92% of the sample, and these disorders were distinguished from Axis I psychotic disorders (20%) with regard to prevalence, patterns of association, and constellation of symptoms. Cluster A disorders were not associated with any Axis I disorder, suggesting diagnostic independence in this sample.