Personality Disorders After Age 50: A Meta-Analytic Review
The literature on personality disorders in late life is sparse and inconclusive, not surprisingly so given the long-standing uncertainty about whether Axis II represents an appropriate nosology for the elderly (Fogel & Westlake, 1990). Various authors have suggested a lower prevalence of personality disorders in old, as opposed to young, adults in clinical and epidemiological samples (Casey 1988; Kroessler, 1990); no differences between elderly males and females (Ames & Molinari, 1994); and fewer personality disorders overall, particularly in Cluster B (Abrams, Rosendahl, Card, & Alexopoulos, 1994; Kunik, Mulsant, Rifai, Sweet, Pasternak, Rosen, & Zubenko, 1994). However, the prevalence of personality disorders in the second half of life essentially remains unknown. A review of prc-DSM-III European field studies uncovered prevalences ranging from 2.8% to 11% among community-dwelling elderly (Gurland & Cross, 1982), but these and subsequent reports have been so methodologically diverse that simple prevalence estimates were precluded. This chapter describes efforts to systematically review the literature on personality disorders after age 50. The principal aim is to discover any trends in the frequency and distribution of personality disorder symptomatology in this age group, and to consider the implications for future research.