The magnitude of cluster c personality disorders and associated factors among psychiatric outpatients at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Abstract Background: Personality disorders (PDs) are complex sets of mental disorders and are characterized by pervasive and enduring patterns of thinking and behaviours. Personality disorders are generally common, with cluster C personality disorders being more prevalent than other clusters in some clinical settings. Cluster C personality disorders are shown to be as severe as cluster B personality disorders in terms of comorbidity, suicidality, and functional impairment. However, information regarding their prevalence and associated factors among psychiatric patients remains limited. Objectives: To assess the magnitude of cluster C personality disorders and associated factors among psychiatric outpatients at Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia, 2023 Methods: An institution-based, cross-sectional study was conducted from October 1st to November 30th, 2023 among 422 patients selected via systematic random sampling technique. Cluster C personality disorders were assessed using the Personality Diagnostic Questionnaire-4+. Data were entered and analyzed using Statistical Package for Social Sciences version 26. Binary and multiple logistic regression analyses were employed to identify factors associated with personality disorders. Odds ratios (OR) with 95% confidence interval (CI) were computed, and a p-value <0.05 was considered significant. Results: A total of 412 outpatients participated in this study, giving a response rate of 97.6%. Males had slight preponderance, constituting 53.6% of all. Patients’ age ranged from 18 to 60 with a median age (interquartile range) of 30 (24–36.75) years. The overall magnitude of cluster C personality disorder was 35.4% (95%CI=30.8–40.1%). Avoidant PD was the most common (100;68.5%) of the cluster C personality disorders. Obsessive-compulsive PD and dependent PD occurred in 62 (42.5%) and 39 (26.7%) of the patients, respectively. Multiple regression analysis showed that being female [AOR=95%CI= 1.67(1.03,2.72)), having higher educational status [AOR(95%CI)= 3.57(1.18,10.79)], being unemployed [AOR(95%CI) =1.90(1.20,3.01)], having positive family history of mental illness [AOR(95%CI) = 2.24(1.31,3.83)]. and poor social support [AOR(95%CI) = 1.84(1.05,3.23)] were associated with cluster C personality disorder among patients. Conclusion and Recommendation: More than one-third (35.4%) of outpatients had cluster C personality disorders, which were associated with female sex, higher educational status, unemployment, positive family history of mental illness, and poor social support. Thus, efforts should be exerted at different levels to screen for these disorders to tailor individualized therapy, thereby improving overall outcomes. III Keywords: Cluster C personality disorder, Avoidant personality disorder, Obsessive compulsive personality disorder, Dependent personality disorder, Mental illness, Outpatients, SPHMMC, Ethiopia