background The introduction of the DSM-III in 1980 has resulted in ideological controversy about possible gender biases that might threaten the validity of psychiatric diagnoses, particularly personality disorders .
aim To critically review the scientific evidence for prevalence differences associated with gender and gender bias in the diagnosis of personality disorders.
method Critical literature review.
results Research shows that: (1) prevalence differences associated with gender are plausible; (2) the nature and size of these differences are to date unknown; (3) gender bias is evident at the level of the clinical evaluation but not at the level of the classification system; and (4) the observed gender bias primarily occurs at the diagnostic but not at the criterion level.
conclusion Empirical studies of gender bias in the diagnosis of personality disorders point to the importance of a thorough examination of personality pathology at the level of the specific diagnostic criteria, for example by using a semistructured interview schedule.