How Many Personality Disorders Are Recognized?
The DSM-5 recognizes 10 distinct personality disorders, organized into three clusters (A, B, and C), though the field is actively transitioning toward dimensional models that may reduce this number. 1
Current DSM-5 Classification
The 10 personality disorders are grouped as follows 1:
- Cluster A (Odd/Eccentric): Paranoid, Schizoid, and Schizotypal personality disorders 1
- Cluster B (Dramatic/Emotional/Erratic): Antisocial, Borderline, Histrionic, and Narcissistic personality disorders 1
- Cluster C (Anxious/Fearful): Avoidant, Dependent, and Obsessive-Compulsive personality disorders 1
Alternative DSM-5 Model (Section III)
The DSM-5 includes an alternative dimensional-categorical hybrid approach that proposes only 5 specific personality disorder types for further research 2, 3:
This alternative model eliminates paranoid, schizoid, histrionic, narcissistic, and dependent personality disorders as formal diagnostic categories, instead representing them through core impairments in personality functioning combined with pathological trait specifications 2, 4. The American Psychiatric Association developed this approach to assess impairments in personality functioning and pathological personality traits across five domains 5.
ICD-11 Approach: A Single Diagnosis
The World Health Organization's ICD-11 (implemented January 2022) replaced all discrete personality disorder categories with a single dimensional diagnosis of "personality disorder." 5 This represents the most significant shift in personality disorder classification:
- The ICD-11 includes only one diagnosis of personality disorder, differentiated by severity (mild, moderate, severe) rather than type 5
- Clinicians can optionally specify maladaptive personality traits including negative affectivity, detachment, dissociality, disinhibition, anankastia, and borderline pattern 5
- This change was made because the division into discrete categories in ICD-10 lacked solid empirical basis, and many patients simultaneously met criteria for multiple personality disorders 5
Clinical Implications
The discrepancy between classification systems reflects ongoing debate about whether personality disorders are best understood as discrete categories or dimensional constructs 6. Studies show that the ICD-11 dimensional approach has greater clinical utility and simplicity, with mental health professionals rating it as more useful for treatment planning and communication with patients compared to categorical systems 5.
For practical purposes in the United States, use the 10 DSM-5 personality disorders for formal diagnosis, while recognizing that future revisions will likely move toward dimensional models with fewer specified types. 1, 2