Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Narcissistic Personality Disorder: Results From the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions
J Clin Psychiatry 2008;69(7):1033-1045
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Objectives: To present nationally
representative findings on prevalence, sociodemographic
correlates, disability, and comorbidity of narcissistic
personality disorder (NPD) among men and women.
Method: Face-to-face interviews with
34,653 adults participating in the Wave 2 National
Epidemiologic Survey on Alcohol and Related Conditions conducted between 2004 and 2005 in
the United States.
Results: Prevalence of lifetime NPD was
6.2%, with rates greater for men (7.7%) than for
women (4.8%). NPD was significantly more prevalent among black men and women and Hispanic
women, younger adults, and separated/divorced/widowed
and never married adults. NPD was associated with
mental disability among men but not women. High co-occurrence rates of substance use, mood, and
anxiety disorders and other personality disorders were
observed. With additional comorbidity controlled
for, associations with bipolar I disorder,
posttraumatic stress disorder, and schizotypal and borderline
personality disorders remained significant, but
weakened, among men and women. Similar
associations were observed between NPD and specific
phobia, generalized anxiety disorder, and bipolar II
disorder among women and between NPD and alcohol
abuse, alcohol dependence, drug dependence, and
histrionic and obsessive-compulsive personality
disorders among men. Dysthymic disorder was
significantly and negatively associated with NPD.
Conclusion: NPD is a prevalent personality
disorder in the general U.S. population and is
associated with considerable disability among men, whose
rates exceed those of women. NPD may not be as stable
as previously recognized or described in the
DSM-IV. The results highlight the need for further
research from numerous perspectives to identify the
unique and common genetic and environmental factors
underlying the disorder-specific associations with
NPD observed in this study.