Personality Disorders in the Public Sector

Using a clinical data base for New York state hospitals, the authors examined the prevalence of DSM-III axis II personality disorders in state hospital patients and explored the patterns of comorbidity between axis I and axis II disorders. They found that 11 percent of the patients received a diagnosis of personality disorder and that these patients were more likely than other patients to have a primary diagnosis of schizoaffective disorder, major affective disorder, dysthymia, and substance use disorder other than alcoholism. Comparison of state hospital data with data from nonstate facilities showed different patterns of coexisting primary diagnoses and personality disorders and a much higher frequency of borderline personality disorder in nonstate patients. Based on the low percentage of state hospital patients diagnosed as having personality disorders, the authors conclude that axis II disorders are underreported in state facilities.