Personality disorders linked to cardiovascular risk

People who are at risk for personality disorders also appear to be at risk for cardiovascular disease, regardless of their socioeconomic status or lifestyle factors, a study in the Journal of Clinical Psychiatry indicates.

"Associations have been found between some personality disorder categories and disability," Dr. Paul Moran, of King's College London, and colleagues write. "However, comparatively little is known about the physical health of people with personality disorder."

In 2000, the researchers tested a random sample of 8,580 adults (ages 16 to 74 years), living in England, Wales, or Scotland, for signs of personality disorders. Self-reports of stroke or ischemic heart disease (blocked arteries that cut off oxygen from the tissue) were ascertained, along with age, sex, social class, self-reported hypertension (high blood pressure) or diabetes, smoking status, and extent of alcohol use.

Overall, 2,462 subjects with personality disorder were identified, for a prevalence of 28.7 percent. A total of 0.6 percent of the subjects reported having a previous stroke, 2.0 percent reported ischemic heart disease, 4.1 percent reported hypertension, and 2.6 percent reported diabetes.

Those with any type of personality disorder had nearly twice the risk of stroke and a 40-percent greater risk of ischemic heart disease, after adjusting the data for known risk factors.

The subject who had a stroke had four times the risk of having an avoidant personality disorder, nearly three times the risk of obsessive-compulsive personality disorder and 8.5-times the risk of having a borderline personality disorder.

Patients with ischemic heart disease had more than twice the risk of avoidant and paranoid personality disorders, 3.6-times the risk of schizotypal personality disorder, and more than seven times the risk of borderline personality disorder.

Dysfunctional personality characteristics may play a direct role in the cause of cardiovascular disease, the investigators conclude.

"Both society and individual sufferers feel the burden of personality disorders," Moran's team writes. "However, in recent years, attention has focused on the risk that people with personality disorder pose to others. Our findings highlight the fact that people with personality disorders are themselves at risk for experiencing serious physical health problems."

SOURCE: Journal of Clinical Psychiatry, January 2007.