Panic Disorder and Personality Disorder Comorbidity

Abstract

The present chapter systematically reviews the relationship between panic disorder, with and without co-occurring anxiety or depression, and current personality disorder. Data were collected with an advanced document protocol according to MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines for observational studies. A comprehensive, computerized literature search was conducted in Medline, PsycINFO, and LILACS. Cohort, case-control and cross-sectional surveys studies evaluating the comorbidity between DSM panic disorder and personality disorders were included. Overall prevalence, comorbidity rates, and 95 % CI were calculated with a random effects model. From 97 initial selected papers, 24 entered in the review. Among patients with a current DSM-III/R/IV panic disorder, 44.3 % (34.6–54.2 %) had any personality disorder; 6.3 % (3.1–10.4 %) had cluster A; 17.9 % (12.2–24.2 %) cluster B, and 34.9 % (25.6–44.7 %) had cluster C. Among patients with a current panic disorder and co-occurring anxiety or depression, 61.8 % (44.6–77.7 %) had any personality disorder, 7.2 % (4.4–10.5 %) had cluster A; 24.0 % (17.6–30.9 %) cluster B, and 38.6 % (25.7–52.2 %) had cluster C. In conclusion, comorbidity between panic disorder and personality disorders is common. Cluster C was the most frequent personality disorder subtype related to panic disorder. Personality disorders were more prevalent among individuals with panic disorder and co-occurring anxiety or depression.