Population prevalence of personality disorder and associations with physical health comorbidities and health care service utilization: A review.

Abstract

Personality disorder (PD), outcomes of diverse comorbid physical health conditions, and the associated burden on health service resources have seldom been studied at a population level. Consequently, there is limited evidence that might inform a public health approach to managing PD and associated mental and physical disability. A review was conducted of population-based studies examining the prevalence of PD and associations between physical comorbidities and service utilization. The prevalence of any PDs were common (4.4% -21.5%) among populations spanning England, Wales, Scotland, Western Europe, Norway, Australia, and the United States. Preliminary evidence supports associations between PDs from Clusters A and B and physical comorbidities, namely cardiovascular diseases and arthritis. PD appears to increase health care utilization, particularly in primary care. In order to facilitate rational population health planning, further population studies are required.

The association between borderline personality disorder and somatoform disorders: A systematic review and meta-analysis

“…The estimated 14% prevalence of BPD among those with somatoform disorders is several times greater than the prevalence of BPD in the population (0.5–5.9%: Lenzenweger et al., ; Grant et al., ; Quirk et al., ), about twice the BPD prevalence in primary care (6.4%: Gross et al., ), and similar to the BPD prevalence in psychiatric inpatients (15%: Widiger & Trull, ). BPD was more common in samples with conversion, somatization, and factitious disorders than in samples with mixed somatoform disorders or hypochondriasis.…”

The Challenge of Transforming the Diagnostic System of Personality Disorders

“…Yet, the ICD-11 proposal advocates for removal of PD types including borderline PD, which affects up to 3% of the general population. Only relatively recently have PDs, and particularly borderline PD, become recognized as common mental disorders associated with increased long-term impairment, morbidity, and mortality among adults (Fok et al, 2014; Quirk et al, 2016). For adolescents, our recognition of PDs as diagnosable conditions (Bjorkenstam, Bjorkenstam, Holm, Gerdin, & Ekselius, 2015; Sharp & Fonagy, 2015) with very serious long-term implications for mental health and social functioning (Moran et al, 2016) is even more recent.…”

Letter: Prescribing and borderline personality disorder

“…However, truly comorbid conditions (such as cardiovascular disease) are also more common among this patient group 1 and the interaction of borderline personality disorder with the management of these conditions often leads to poor outcomes, including premature mortality. 2 Of the possible mechanisms that might underlie these poor outcomes, the relational difficulties that lie at the heart of borderline personality disorder are commonly enacted with health professionals. This often leads to suboptimal clinical decision making by the health professionals or poor self-care by the patients.…”