Risk and Protective Factors for Personality Disorders

An Umbrella Review of Published Meta-Analyses of Case–Control and Cohort Studies

Dados Bibliográficos

ID15518488
AutoresMarco Solmi (0000-0003-4877-7233, University of Ottawa, autor correspondente), Elena Dragioti (0000-0001-9019-4125, Linköping University), Giovanni Croatto (0000-0003-0591-3936, University of Padua), Joaquim Radua (0000-0003-1240-5438, Consorci Institut D'Investigacions Biomediques August Pi I Sunyer), Stefan Borgwardt (0000-0002-5792-3987, University of Lübeck), André F Carvalho (0000-0002-2500-5671, Centre for Addiction and Mental Health), Jacopo Demurtas (0000-0003-3001-8546, University of Modena and Reggio Emilia), Anna Mosina (0000-0002-2134-7463, Clienia AG), Peter K Kurotschka (0000-0003-3750-6147), Peter Kurotschka, Trevor Thompson (0009-0005-0226-395X, University of Greenwich), Samuele Cortése (0000-0001-5877-8075, Solent NHS Trust), Jung-Im Shin (0000-0003-2326-1820, Yonsei University, autor correspondente), Jae Il Shin, P Fusar‐poli (0000-0003-3582-6788, South London and Maudsley NHS Foundation Trust), Paolo Fusar-Poli
Ano2021
Volume12
Páginas679379-679379
Data de publicação2021-09-06
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoFrontiers in Psychiatry (JOURNAL)
Identificadores do periódicoISSN: 1664-0640 • E-ISSN: 1664-0640
EditoraFrontiers Media (PUBLISHER • CH)
DOI10.3389/fpsyt.2021.679379
PMID34552513
OpenAlexW3195528067
IdiomaEN
Citações recebidas5
Referências citadas54

The putative risk/protective factors for several personality disorders remain unclear. The vast majority of published studies has assessed personality characteristics/traits rather than disorders. Thus, the current umbrella review of meta-analyses (MAs) aims to systematically assess risk or protective factors associated with personality disorders. We searched PubMed-MEDLINE/PsycInfo databases, up to August 31, 2020. Quality of MAs was assessed with AMSTAR-2, while the credibility of evidence for each association was assessed through standard quantitative criteria. Out of 571 initial references, five meta-analyses met inclusion criteria, encompassing 56 associations of 26 potential environmental factors for antisocial, dependent, borderline personality disorder, with a median of five studies per association, and median 214 cases per association. Overall, 35 (62.5%) of the associations were nominally significant. Six associations met class II (i.e., highly suggestive) evidence for borderline personality disorder, with large effect sizes involving childhood emotional abuse (OR = 28.15, 95% CI 14.76-53.68), childhood emotional neglect (OR = 22.86, 95% CI 11.55-45.22), childhood any adversities (OR = 14.32, 95% CI 10.80-18.98), childhood physical abuse (OR = 9.30, 95% CI 6.57-13.17), childhood sexual abuse (OR = 7.95, 95% CI 6.21-10.17), and childhood physical neglect (OR = 5.73, 95% CI 3.21-10.21), plus 16 further associations supported by class IV evidence. No risk factor for antisocial or dependent personality disorder was supported by class I, II, and III, but six and seven met class IV evidence, respectively. Quality of included meta-analyses was rated as moderate in two, critically low in three. The large effect sizes found for a broad range of childhood adversities suggest that prevention of personality disorders should target childhood-related risk factors. However, larger cohort studies assessing multidimensional risk factors are needed in the field

Antisocial personality disorder · Borderline personality disorder · Child abuse · Injury prevention · MEDLINE · Meta-analysis · Personality · Personality disorders · Physical abuse · Poison control · Psychiatry · Psychological abuse · PsycINFO · Clinical Psychology · Medicine · Personality Disorders and Psychopathology · Psychology · Psychopathy, Forensic Psychiatry, Sexual Offending · Suicide and Self-Harm Studies · Internal Medicine