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The impact of a diagnosis of personality disorder on service usage in an adult Community Mental Health Team

Social Psychiatry and Psychiatric Epidemiology volume 49, pages 307–316 (2014)Cite this article

Abstract

Purpose

Patients with a diagnosis of personality disorder (PD) have multiple and diverse needs. It has been noted that individuals with personality disorder are high users of health care resources, especially psychiatric services, ambulance services and emergency departments. In addition PD has been shown to be a significant predictor of disability and mental health consultations independent of Axis I disorders and physical conditions. This study aimed to compare the patterns of service usage, clinical ratings of symptoms and functioning, as well as demographic and clinically relevant historical variables between a group of patients with PD and a random sample of all other patients registered with a South London Community Mental Health Team.

Methods

A case–control design was used to examine service usage patterns over a one-year period for 73 cases and 96 controls. Diagnoses were established by clinician discussion. Clinical outcomes were measured with Health of the Nation Outcome Scales and Global Assessment of Functioning, while service use was recorded using ten variables obtained from case note review.

Results

People with a diagnosis of PD were more often white and had a history of abuse, particularly childhood emotional abuse. They were higher users of some aspects of the service as compared to controls, and had significantly higher severity of symptoms and poorer functioning on clinician-rated measures.

Conclusion

This study confirms previous findings that people with PD have more severe symptomatology and greater degrees of functional impairment when compared to those without. Community clinicians should routinely screen attenders to predict likely difficulties that might arise and to make provision for these difficulties in the treatment and management of clients.

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Notes

  1. All patients in services were at that time categorised as having standard or enhanced needs.

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Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Affiliations

  1. South London & Maudsely NHS Foundation Trust, London, N4 2ES, UK

    M. Byrne, S. Henagulph, R. J. McIvor, J. Ramsey & J. Carson

  2. Institute of Psychiatry, Kings College London, De Crespigny Park, London, SE5 8AF, UK

    M. Byrne

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  1. M. Byrne
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  2. S. Henagulph
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  3. R. J. McIvor
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  4. J. Ramsey
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  5. J. Carson
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Correspondence to S. Henagulph.

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Byrne, M., Henagulph, S., McIvor, R.J. et al. The impact of a diagnosis of personality disorder on service usage in an adult Community Mental Health Team. Soc Psychiatry Psychiatr Epidemiol 49, 307–316 (2014). https://doi.org/10.1007/s00127-013-0746-3

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  • DOI: https://doi.org/10.1007/s00127-013-0746-3

Keywords

  • Personality disorder
  • Service use
  • Community Mental Health Team