Cluster B personality disorders among psychiatric outpatients in Southwest Ethiopia: Institution-based cross-sectional study

Background: Diagnosis of co-occurring personality disorders, particularly the most comorbid cluster B personality disorders in psychiatric patients is clinically important because of their association with the duration, recurrence, and outcome of the comorbid disorders. The aim of the study was to assess the prevalence of cluster B personality disorders and associated factors among psychiatric outpatients in Jimma Medical Center. Methods: : An institution-based cross-sectional study was conducted among 404 patients with mental illnesses at Jimma Medical Center, psychiatry clinic, from July 15 to September 14, 2021. A systematic random sampling method was used to recruit the participants. Personality disorder questionnaire four (PDQ-4) was used to assess the prevalence of cluster B personality disorders through a face-to-face interview. Data were entered into Epi Data Version 4.6 and exported to SPSS Version 26 for analysis. Logistic regression analysis was done and variables with a p-value less than 0.05 with a 95% confidence interval in the final fitting model were declared as independent predictors of cluster B personality disorders. Result: Amongst 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. Unable to read and write(AOR = 3.28, 95%CI = 1.43 - 7.51), unemployment(AOR = 2.32, 95%CI = 1.19 - 4.49), diagnosis of depressive (AOR = 3.72, 95%CI = 1.52-9.10) and bipolar-I disorders (AOR = 2.94, 95%CI = 1.37 - 6.29), longer duration of illness (AOR = 2.44, 95%CI = 1.33 - 4.47), multiple relapses (AOR = 2.21, 95%CI = 1.18 – 4.15)), history of family mental illnesses (AOR = 2.05, 95%CI = 1.17 - 3.62), recent cannabis use (AOR = 4.38, 95%CI = 1.61 - 11.95), recent use of alcohol (AOR = 2.86, 95%CI = 1.34 - 6.10), starting to use substance at earlier age (AOR = 4.42, 95%CI = 1.51 -12.96), and suicidal attempt (AOR = 2.24, 95%CI= 1.01 - 4.96) , 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 found to be important for mental health professionals working in the outpatient departments to screen for the cluster B personality disorders as part of their routine activities, particularly those who have mood disorders, longer duration of illness, multiple relapses, history of family mental illnesses, suicidal attempt and are a current user of alcohol and cannabis.