Prevalence of Personality Disorder Diagnosed with SCID-II Among Psychiatry Patients in Turkey: Systematic Review and Meta-Analysis.

Objective: To review and summarize data on the prevalence of overall personality disorder extracted from SCID-II (Structured Clinical Interview for DSM-III Axis II Disorders) studies conducted in Turkey with samples consisting of mental health consumers, and also to elaborate on the level and sources of heterogeneity.

Method: MEDLINE, WOS, PsycINFO, ScienceDirect databases as well as the Turkish Psychiatric Database have been systematically searched. Relevant studies conducted with samples composed of psychiatric inpatients or outpatients receiving psychiatric treatment were included. The diagnostic rate of any personality disorder was regarded as the valid indicator of the overall personality disorder prevalence; therefore, papers presenting data not conducive to this goal were excluded.

Results: A total of 311 papers were identified, and 55 studies were included in the qualitative synthesis. Following a critical appraisal of the quality of the data involving point prevalence rates ranging from 20% to 100%, we decided to include 35 studies in the quantitative synthesis. A random-effects meta-analysis followed by a subgroup analysis yielded a summary estimate of 52% [46 - 58%] for the prevalence of overall personality disorder. A high level of overall heterogeneity 84.8 % [80.0 - 88.4] was found to persist in each diagnostic subgroup with a particular primary diagnosis.

Conclusion: The prevalence estimates derived from the meta-analysis of the SCID-II studies conducted in Turkey support the notion that personality disorder is present in nearly half of the mental health service consumers. That the level of heterogeneity across studies originating from Turkey alone was as high as those observed in previous reviews covering studies originating from various countries suggests that the very source of such heterogeneity might be questionable validity and reliability of SCID-II diagnoses.