Treatment Utilization by Patients With Personality Disorders

Bender, Donna S.; Dolan, Regina T.; Skodol, Andrew E.; Sanislow, Charles A.; Dyck, Ingrid R.; McGlashan, Thomas H.; Shea, M. Tracie; Zanarini, Mary C.; Oldham, John M.; Gunderson, John G.

doi:10.1176/appi.ajp.158.2.295

Cited by 683 publications

(476 citation statements)

References 33 publications

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“…Individuals with BPD also reported significantly more outpatient medical visits than any other group and differences in the total number of days spent in the hospital for nonpsychiatric reasons. These findings match the results of previous investigations of treatment utilization by patients with BPD [9,18].…”

Section: Discussionsupporting

confidence: 91%

“…Psychosocial impairment, particularly with social relationships, also seems relatively stable over time [6] Research has also examined the impact that PD diagnoses have on psychiatric and medical treatment utilization. Previous studies on individuals with PD diagnoses demonstrated that BPD individuals differ in usage of outpatient, inpatient, and psychopharmacologic treatments when compared to other PD groups [7,8] and when compared to major depression groups without PD [9]. Patients with BPD also receive more psychotropic medications when compared to all other non-PD diagnostic groups [10,11].…”

Section: Introductionmentioning

confidence: 99%

“…A healthy comparison group is advantageous in providing a context for specific psychosocial impairment while elucidating areas of general psychosocial impairment. A psychiatric comparison group composed of mood and anxiety disorders would extend previous investigations comparing patients with PDs to patients with major depression [4,9]. The inclusion of a variety of anxiety and mood disorders would accurately reflect the increased rates of comorbidity of these disorders in patients with BPD [12,13] and would expand upon understanding of the specific psychosocial impairments present in patients with PDs above and beyond patients with a variety of mood or anxiety disorders (MADs).…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Ansell

Sanislow

McGlashan

et al. 2007

Comprehensive Psychiatry

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125

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This study compared psychosocial functioning and treatment utilization in 130 participants who were diagnosed with a borderline personality disorder (BPD), a non-BPD personality disorder (OPD), a mood and/or anxiety disorder (MAD), or had no current psychiatric diagnosis and served as a healthy comparison group. Diagnostic and Statistical Manual of Mental Disorders (4th Edition) diagnoses, psychosocial functioning, and treatment utilization were determined by using well-established semistructured research interviews conducted by trained doctoral-level clinicians. Analysis of variance revealed the most severe deficits in functioning characterized the BPD group across areas of global functioning with more moderate impairments in functioning occurring in OPD and MAD groups. The BPD group was characterized by significantly greater psychiatric and nonpsychiatric treatment utilization than the other groups. These findings indicate that BPD as well as other personality disorders are a source of considerable psychologic distress and functional impairment equivalent to, and at times exceeding, the distress found in mood and anxiety disorders. The public health impact of BPD diagnosis is highlighted by the high rates of psychiatric and nonpsychiatric treatment utilization. D

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Ansell

Sanislow

McGlashan

et al. 2007

Comprehensive Psychiatry

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125

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“…Additional subjects were recruited via postings or advertising. All were previously or currently in treatment (Bender et al 2001). Participants were prescreened to determine age eligibility and treatment status and to exclude patients with active psychosis, acute substance intoxication or withdrawal or other confusional states, or a history of schizophrenia or schizoaffective disorder.…”

Section: Subjectsmentioning

confidence: 99%

Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

et al. 2004

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Background. A defining feature of personality disorder (PD) is an enduring pattern of inner experience and behavior that is stable over time. Follow-up and follow-along studies have shown considerable diagnostic instability of PDs, however, even over short intervals. What, then, about personality disorder is stable ? The purpose of this study was to determine the stability of impairment in psychosocial functioning in patients with four different PDs, in contrast to patients with major depressive disorder (MDD) and no PD, prospectively over a 2-year period.

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“…[1][2][3] Studies cite BPD rates of approximately 0.4% to 1.8% among community samples, [4][5][6][7] and 10% to 25% among clinical samples. 8,9 BPD is more often diagnosed in women, with estimates that approximately two thirds to three quarters of those diagnosed with BPD are women.…”

mentioning

confidence: 99%

Gender differences in borderline personality disorder: findings from the collaborative longitudinal personality disorders study

Johnson¹,

Shea²,

Yen³

et al. 2003

Comprehensive Psychiatry

192

118

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A majority of the literature on borderline personality disorder (BPD) focuses on its occurrence in women or does not specifically assess for gender differences in clinical presentations. Some studies report that men with BPD may be more likely to be diagnosed with substance use disorders, as well as paranoid, passiveaggressive, narcissistic, sadistic, and antisocial personality disorders (PDs). Additionally, women with BPD appear to be more likely to report histories of adult physical and sexual abuse and to meet diagnostic criteria for post-traumatic stress disorder (PTSD) and eating disorders. The purpose of the present study was to further examine gender differences in BPD. Using baseline data from the Collaborative Longitudinal Personality Disorders Study (CLPS), men and women who met criteria for BPD were compared on current axis I and II disorders, BPD diagnostic criteria, childhood trauma histories, psychosocial functioning, temperament, and personality traits. Men with BPD were more likely to present with substance use disorders, and with schizotypal, narcissistic, and antisocial PDs, while women with BPD were more likely to present with PTSD, eating disorders, and the BPD criterion of identity disturbance. Generally speaking, women and men with BPD displayed more similarities than differences in clinical presentations. The differences that did emerge are consistent with those found in epidemiological studies of psychopathology and therefore do not appear unique to BPD. Additionally, many gender differences traditionally found in epidemiological samples did not emerge in BPD subjects. For example, no difference was found in rates of major depressive disorder, a condition that is more prevalent in females. Thus, BPD pathology may be a prevailing characterization that can attenuate usual gender-based distinctions. © 2003 Elsevier Inc. All rights reserved. B ORDERLINE personality disorder (BPD) isassociated with significant morbidity and frequent use of mental health resources. 1-3 Studies cite BPD rates of approximately 0.4% to 1.8% among community samples, 4-7 and 10% to 25% among clinical samples. 8,9 BPD is more often diagnosed in women, with estimates that approximately two thirds to three quarters of those diagnosed with BPD are women. 6,9-12 Consequently, a majority of the literature on BPD focuses on its occurrence in women 13 or does not incorporate gender as a separate variable, therefore not addressing possible gender differences in clinical presentations. 14,15 Thus, little is known regarding potential gender differences in persons with BPD that may impact the manifestation, course, and treatment of BPD in both men and women.Although BPD is believed to occur more frequently in women, research findings on the prevalence of BPD in men and women are inconsistent. In some studies, when significant differences in rates of personality disorders (PD) are found, rates are usually higher among men. [16][17][18][19] One of the more methodologically sound community studies 7 found that men had higher rates...

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Treatment Utilization by Patients With Personality Disorders

Cited by 683 publications

References 33 publications

Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Psychosocial impairment and treatment utilization by patients with borderline personality disorder, other personality disorders, mood and anxiety disorders, and a healthy comparison group

Stability of functional impairment in patients with schizotypal, borderline, avoidant, or obsessive–compulsive personality disorder over two years

Gender differences in borderline personality disorder: findings from the collaborative longitudinal personality disorders study

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