An epidemiological study of histrionic personality disorder

Area of Science:

• Psychiatry
• Epidemiology
• Mental Health Research

Background:

• The Epidemiological Catchment Area (ECA) survey aimed to assess mental health in community populations.
• Previous studies suggested a higher prevalence of Histrionic Personality Disorder (HPD) in females, often based on hospital-based samples.

Purpose of the Study:

• To determine the reliability and validity of the DSM-III diagnosis of Histrionic Personality Disorder in a general community sample.
• To establish the prevalence of HPD in the general population and examine gender distribution.
• To identify associated clinical features and healthcare utilization patterns for individuals with HPD.

Main Methods:

• A two-stage probability sample of community subjects was selected in Baltimore, MD.
• Full psychiatric examinations were conducted using DSM-III criteria for diagnosis.
• Data analysis focused on subjects diagnosed with Histrionic Personality Disorder.

Main Results:

• The DSM-III diagnosis of Histrionic Personality Disorder was found to be reliable and a valid construct.
• The prevalence of HPD in the general population was determined to be 2.1%.
• Males and females were equally affected, challenging prior assumptions of higher female prevalence due to ascertainment bias in clinical settings. The disorder is associated with emotional, behavioral, and social impairments and higher healthcare facility use.

Conclusions:

• Histrionic Personality Disorder is a valid and reliably diagnosed condition in the general population.
• The equal prevalence in males and females suggests previous findings were influenced by sampling bias.
• HPD is associated with significant functional impairments and increased healthcare seeking behaviors.