Differential profile of three overlap psychiatric diagnoses using temperament and character model: A systematic review and meta-analysis of avoidant personality disorder, schizoid personality disorder, and social anxiety disorder

Abstract

Some psychiatric disorders are mostly overlapping and measures for facilitating differential profiles play a key role in the identification of a disease, course, prognosis, and management. This systematic review and meta-analysis aimed to (i) explore the association between the components of temperament and character model and three overlap psychiatric diagnoses including avoidant personality disorder (APD), schizoid personality disorder (SPD), and social anxiety disorder (SAD) and (ii) provide differential profiles for each of these disorders. The literature search was performed on 7 international scientific databases for all articles published in English, January 1990-June 2019. The pooled effect sizes were obtained using the correlation coefficients or the standardized mean differences between cases with SAD and healthy controls by the random-effects method. Fifteen correlational studies for APD and SPD and eight case–control studies for SAD met the criteria for entering meta-analysis. All three disorders were positively associated with harm avoidance (HA) and negatively associated with novelty seeking (NS), self-directedness (SD), and cooperativeness. APD and SPD were also negatively associated with reward dependence (RD). The differential profiles are as follows: NS (APD < SAD), HA (APD > SPD, SAD), RD (SPD < APD < SAD), SD (APD < SPD, SAD), cooperativeness (APD, SPD < SAD), and self-transcendence (ST: APD > SPD, SAD). It seems that HA, SD, and cooperativeness are the common core of these three diagnostic categories. More extreme tendencies in NS and RD, along with ST with a lower possibility, are the main traits in the differential profiles.