Prevalence of cluster b personality disorders and associated Factors among patients with mental illnesses attending Psychiatric outpatient treatment at jimma medical center, Jimma, southwest ethiopia, 2021

Abstract

Background: Diagnosing co-occurring personality disorders, particularly cluster B personality disorders the most comorbid one, in psychiatric patients is clinically important because of their association with the duration, recurrence, and outcome of the comorbid disorders. Objective: To assess the prevalence of cluster B personality disorders and associated factors among patients with mental illnesses attending psychiatric outpatient treatment at JMC,2021. Methods: An institutional-based cross-sectional study was employed among 404 patients with mental illnesses. A systematic random sampling method was utilized to select the patients from Jimma medical center, psychiatry clinic, from July 15 to September 14, 2021. Personality disorder questionnaire four (PDQ-4) was used to assess the prevalence of cluster B personality disorders through a face-to-face interview. Data was entered into Epi Data Version 4.6 and exported to SPSS Version 26 for analysis. Descriptive analysis was done using frequency, percentage, mean and standard deviation. Logistic regression analysis was done and variables with a p-value less than 0.05 with 95% confidence interval in the final fitting model were declared as independent predictors of cluster B personality disorders. Result: Among 401 respondents with response rate of 99.3%, slightly less than one-fourth (23.19%, N=93) were found to have cluster B personality disorders, from which (8.7%, N=35) were borderline, (7.2%, N=29) antisocial, (6.5%, N=26) narcissistic, and (3.2%, N=13) histrionic personality disorder. Diagnosis of depressive (AOR=3.33, 95%CI=1.59–6.97)) and bipolar-I disorders (AOR=2.76, 95%CI=1.16–6.56)), longer duration of illness (AOR=2.22, 95%CI=1.24–3.98)), multiple relapses (AOR=2.21, 95%CI=1.18–4.15)), history of family mental illnesses (AOR=2.33, 95%CI=1.26–4.30)), recent cannabis use (AOR =5.73, 95%CI=2.16–15.24)), starting to use substance at earlier age (AOR=4.77, 95%CI=1.71– 13.33),suicidal attempt (AOR=3.17, 95%CI=1.39–7.26), emotional abuse(AOR=2.85, 95%CI=1.44–5.63), and interpersonal functioning impairments (AOR=3.74, 95%CI=1.99– 7.02) were the factors significantly associated with cluster B personality disorders. Conclusion: The prevalence of cluster B personality disorders was high among mentally ill outpatients and it is found to be important for mental health professionals working on the outpatient departments to screen for cluster B PD as part of their routine activities. Having diagnosis of mood disorders, longer duration of illness, multiple relapses, history of family mental illnesses, recent cannabis use, starting to use substance at earlier age, suicidal attempt, emotional abuse, and interpersonal functioning impairments were significantly associated with cluster B personality disorders