The study follows WHO field test protocols and is focused on testing cultural appropriateness and inter-rater reliability. The aim of the current study was to test the reliability and the cultural applicability of the Urdu translation of the IPDE in Pakistan in a clinical outpatient population. 8, 9 The instrument is designed for use by clinicians (psychiatrists or clinical psychologists) experienced in the assessment of personality disorders.Īs far as we are aware no study of prevalence of personality disorder was conducted in Pakistan. Keeping in view that the basic assessment tool should be culturally applicable and reliable and easily understandable by local people, it was translated into different languages e.g. 6 The un-weighted prevalence of personality disorders from a British survey showed that 10.7% of the sample (4.4% weighted) had at least one disorder, with men more likely to have a disorder (13.3% weighted 5.4%) compared with women (8.7% weighted 3.4%). The most prevalent personality disorder in the general population was obsessive-compulsive personality disorder (7.88%), followed by paranoid personality disorder (4.41%) and antisocial personality disorder (3.63%). Overall, 14.79% of adult Americans (30.8 million), had at least 1 personality disorder. It consists of a screening questionnaire as well, which consists of 59 items, which are self-reported by the patient as true or false. 4 ICD-10 manual of IPDE consists of 67 items. 4 Moreover in ICD-10 borderline and impulsive are considered subtypes of emotionally unstable personality disorder, and narcissistic personality disorder is not included. ICD-10 has anankastic, anxious and dissocial instead of obsessive compulsive, avoidant and antisocial personality disorders respectively. 4, 5 There is difference in nomenclature as well as in diagnostic criteria. Both these classificatory systems are overlapping but different. 1 IPDE has two manuals to assess personality disorders, one according to DSM IV and the other according to ICD-10. The IPDE is a semi structured clinical interview, used as an evaluation tool to assess the personality disorders in ICD-10 (International classification of disease, 10 th edition) and DSM IV (Diagnostic and Statistical Manual of Mental Disorders, 4 th edition) classification systems. The probability of consulting and receiving effective treatment from psychiatric services varies according to demography, degree of disability and diagnosis. Personality disorders are associated with a significant burden on the individuals with the disorder, those around them and on society in general but studies of the prevalence of personality disorders (PDs) have been fewer and on smaller-scale. 1 The main aim was the development and standardization of diagnostic assessment instrument for use in clinical research around the world. The International personality disorder examination (IPDE) was developed within the Joint Program for the Diagnosis and Classification of Mental Disorders of the World Health Organization (WHO) and US Alcohol, Drug Abuse and Mental Health Administration (ADAMHA). Correlation coefficient for dimensional scores between the two raters was 0.392 for paranoid personality disorder, 0.842 for anankastic and around 0.9 for the rest of the personality disorders, each.Ĭonclusion: Urdu translation of IPDE is a reliable tool to screen and diagnose personality disorders in population of Pakistan. Most prevalent personality disorder was emotionally unstable borderline type with a phi correlation of 0.831, followed by emotionally unstable impulsive type and anankastic personality disorder with phi correlations of 0.930 and 0.867, respectively, for definite cases. Majority of patients had more than one personality disorder. The mean age of the sample was 28.5 +6.08 years. Results: Out of 30 enrolled patients, 25(83.3%) were females. The analysis was carried out using SPSS v.20. The final Urdu draft was obtained after incorporating modifications suggested by experts following a feasibility study. Linguistic equivalence was assessed through back- translation and conceptual equivalence through opinion of mental health experts. For translation, permission was taken from World Health Organization. Two interviewers conducted the interviews simultaneously, to ensure inter-rater reliability. Those who scored positive on screening were evaluated in a detailed interview using IPDE. Patients considered to have a personality disorder by a psychiatrist were initially screened by the IPDE screening questionnaire. Methods: This study was conducted at the outpatient department of Fatima Memorial Hospital Lahore from April 2012 to March 2013. Objective: To test the reliability and applicability of Urdu translation of the International personality disorder examination (IPDE) in a psychiatric outpatient population in Pakistan.
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