Journal article : Review
Personality disorders, violence and antisocial behaviour: updated systematic review and meta-regression analysis
- Abstract:
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Background
Links between personality disorders and antisocial outcomes has not examined individual personality disorders, and the contribution of comorbidities remain uncertain. Previous systematic reviews are dated.
Aims
To synthesise evidence from observational studies on the risk of antisocial outcomes and recidivism associated with personality disorders.
Method
We searched six bibliographic databases (up to March 2024) for observational studies examining the risk of antisocial behaviour, interpersonal violence and recidivism in individuals diagnosed with personality disorders, compared to controls. We explored sources of heterogeneity using subgroup analyses and meta-regression.
Results
We identified 21 studies involving 83 418 individuals with personality disorders from 10 countries examining antisocial and violent outcomes (Aim 1), and 39 studies of 14 131 individuals from 13 countries with recidivism (or repeat offending) as the outcome (Aim 2). We found increased risks of violence among individuals with any personality disorder (odds ratio 4.5, 95% CI 3.0–6.7), particularly antisocial personality disorder (odds ratio 7.6, 95% CI 5.1–11.5) and borderline personality disorder (odds ratio 2.6, 95% CI 1.8–3.9). Individuals with any personality disorder (odds ratio 2.3, 95% CI 2.0–2.6) and antisocial personality disorder (odds ratio 2.8, 95% CI 1.6–4.9) also demonstrated an elevated risk of recidivism. Personality disorder types and comorbid substance use disorder were associated with between-study heterogeneity.
Conclusions
The assessment and management of personality disorders should be considered as part of violence prevention strategies. Improving identification and treatment of comorbid substance misuse may reduce adverse outcomes in individuals with personality disorders.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Version of record, pdf, 725.7KB, Terms of use)
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- Publisher copy:
- 10.1192/bjp.2024.226
Authors
+ Wellcome Trust
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- Funder identifier:
- https://ror.org/029chgv08
- Grant:
- 202836/Z/16/Z
- Publisher:
- Cambridge University Press
- Journal:
- British Journal of Psychiatry More from this journal
- Volume:
- 227
- Issue:
- 1
- Pages:
- 481-491
- Place of publication:
- England
- Publication date:
- 2024-12-11
- Acceptance date:
- 2024-09-30
- DOI:
- EISSN:
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1472-1465
- ISSN:
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0007-1250
- Pmid:
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39659141
- Language:
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English
- Keywords:
- Subtype:
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Review
- Pubs id:
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2070419
- Local pid:
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pubs:2070419
- Deposit date:
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2025-01-17
- ARK identifier:
Terms of use
- Copyright holder:
- Chow et al
- Copyright date:
- 2024
- Rights statement:
- © The Author(s), 2024. Published by Cambridge University Press on behalf of Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
- Licence:
- CC Attribution (CC BY)
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