Personality disorders and physical comorbidities in adults from the United States: data from the National Epidemiologic Survey on Alcohol and Related Conditions

  • Shae E. Quirk
  • Renée El-Gabalawy
  • Sharon L. Brennan
  • James M. Bolton
  • Jitender Sareen
  • Michael Berk
  • Andrew M. Chanen
  • Julie A. Pasco
  • Lana J. Williams
Original Paper



There is a paucity of research examining the relationship between personality disorders (PDs) and chronic physical comorbidities. Consequently, we investigated associations between individual PDs and PD Clusters, and various common disease groups [cardiovascular disease (CVD), diabetes, arthritis and gastrointestinal disease (GI)] in a nationally representative survey of adults from the United States.


This study utilized pooled data (n = 34,653; ≥20 years) from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. PDs were assessed using the Alcohol Use Disorder and Associated Disabilities Interview Schedule- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Physical conditions were based on self-reports of being diagnosed by a health professional. Unadjusted and adjusted logistic regressions examined the relationship between PDs and physical conditions.


After adjustment (sociodemographic factors, past-year mood, anxiety and substance use disorders), Clusters A, B and C PDs were each associated with physical conditions (all p ≤ 0.01). Of the individual PDs, schizoid, schizotypal, narcissistic, borderline and obsessive–compulsive PDs were associated with CVD (all p ≤ 0.01) among younger adults. Paranoid, antisocial, borderline and avoidant PDs and younger adults with schizoid, schizotypal and obsessive–compulsive PDs were each associated with arthritis (all p ≤ 0.01). Significant associations were seen between paranoid, schizoid and schizotypal PDs and diabetes (all p ≤ 0.01). Finally, schizotypal, antisocial, borderline and narcissistic PDs were associated with GI conditions (all p ≤ 0.01).


PDs were consistently associated with physical conditions. Investigation of PDs and their relationship with physical health outcomes warrant further research attention as these findings have important clinical implications.


Personality disorders Comorbidity Physical conditions NESARC 



Shae E Quirk is supported by a National Health and Medical Research Council (NHMRC of Australia) Postgraduate Scholarship (GNT1076347). Renée El-Gabalawy has received a Manitoba Graduate Scholarship, and a Vanier Canada Graduate Scholarship from the Canadian Institutes of Health Research. Sharon Brennan has received Grant/Research support from The University of Melbourne, and is supported by an Early Career Research Fellowship from the NHMRC (GNT1012472). James Bolton has received Grant/Research support from the Canadian Institutes of Health Research, and the Manitoba Health Research Council. Michael Berk has received Grant/Research Support from the National Institute of Health (USA), Simons Foundation, CRC for Mental Health, Stanley Medical Research Institute, Medical Benefits Fund, National Health and Medical Research Council (NHMRC of Australia), Beyond Blue, Geelong Medical Research Foundation, Bristol Myers Squibb, Eli Lilly, Glaxo SmithKline, Organon, Novartis, Mayne Pharma, Servier and Astra Zeneca. He has been a paid consultant for Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Glaxo SmithKline, Janssen Cilag, Lundbeck and Pfizer and a paid speaker for Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Glaxo SmithKline, Janssen Cilag, Lundbeck, Organon, Pfizer, Sanofi Synthelabo, Solvay and Wyeth and is supported by a NHMRC Senior Principal Research Fellowship (GNT1059660). Andrew Chanen has received research funding from the National Health and Medical Research Council (NHMRC of Australia), Australian Research Council, Colonial Foundation, The University of Melbourne, and the New South Wales Department of Health. Lana Williams has received Grant/Research support from Eli Lilly, Pfizer, The University of Melbourne, Deakin University and the National Health and Medical Research Council (NHMRC of Australia), is supported by a NHMRC Career Development Fellowship (GNT1064272).

Conflict of interest

The authors have no conflict of interest to declare.

Ethical standard

The US Census Bureau and the US Office of Management and Budget reviewed the research protocol and provided full ethical approval and therefore performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Shae E. Quirk
    • 1
  • Renée El-Gabalawy
    • 2
  • Sharon L. Brennan
    • 1
    • 3
  • James M. Bolton
    • 2
  • Jitender Sareen
    • 2
  • Michael Berk
    • 1
    • 4
    • 5
    • 6
  • Andrew M. Chanen
    • 6
  • Julie A. Pasco
    • 1
    • 3
  • Lana J. Williams
    • 1
  1. 1.IMPACT Strategic Research Centre, School of MedicineDeakin UniversityGeelongAustralia
  2. 2.Departments of Psychiatry, Psychology, and Community Health SciencesUniversity of ManitobaWinnipegCanada
  3. 3.Department of Medicine, NorthWest Academic Centre, Sunshine HospitalThe University of MelbourneSt AlbansAustralia
  4. 4.Department of PsychiatryThe University of MelbourneMelbourneAustralia
  5. 5.Mental Health Research InstituteMelbourneAustralia
  6. 6.Orygen Youth Health Research Centre and Centre for Youth Mental HealthThe University of MelbourneMelbourneAustralia

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