The Economic Burden of Personality Disorders in Mental Health Care
Abstract
OBJECTIVE: Some evidence suggests that personality disorders are associated with a high economic burden due to, for example, a high demand on psychiatric, health, and social care services. However, state-of-the-art cost studies for the broad range of personality disorder diagnoses are lacking. The present study examines the direct medical costs, as well as the indirect costs, of patients seeking mental health treatment with DSM-IV personality disorders. METHOD: The 1740 subjects included in this study were recruited from March 2003 to March 2006 from 6 different mental health care institutes in the Netherlands specializing in the psychotherapeutic treatment of personality disorders. The direct and indirect costs were assessed using the Trimbos and Institute for Medical Technology Assessment Questionnaire on Costs Associated with Psychiatric Illness. Personality disorders were diagnosed using the Structured Interview for DSM-IV Personality. RESULTS: The mean total costs of the personality disorder group in the 12 months prior to treatment were 11,126 euros per patient. Two thirds (66.5%) of these costs consisted of direct medical costs, while the remaining costs were related to productivity losses. Borderline and obsessive-compulsive personality disorders were uniquely associated with increased mean total costs. CONCLUSIONS: Treatment-seeking patients with personality disorders pose a high economic burden on society, a burden substantially higher than that found in, for instance, depression or generalized anxiety disorder. These high societal costs present a strong argument in favor of prioritizing effective personality disorder treatments in reimbursement decisions.
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BPD results in a high burden of disease and considerable societal costs.
“In addition, people with BPD often have poor physical health [3] and excess mortality from medical conditions [1] resulting in a high burden of disease and considerable societal costs [7, 8].”
Personality disorders have been associated with similar or higher societal costs than mood and anxiety disorders.
“Personality disorders (PDs) are now being accepted as important conditions in mainstream psychiatry and have been associated with similar or higher costs to society than mood and anxiety disorders [9–11]”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [10]
Soeteman et al calculated the total burden of personality disorder in the Netherlands to be £11,126 per patient.
“They calculated the total burden of personality disorder in the Netherlands to be £11,126 per patient”
From Personality disorder: a new global perspective (2010) · cites this paper as [23]
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“In addition, people with BPD often have poor physical health [3] and excess mortality from medical conditions [1] resulting in a high burden of disease and considerable societal costs [7, 8].”
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- Authors
- Soeteman, D. I., Hakkaart-van Roijen, L., Verheul, R., & Busschbach, J. J. V.
- Affiliations
- De Viersprong (NL)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2008-02-15
- Volume
- 69
- Issue
- 2
- Pages
- 259-265
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2142467951
- Cited by
- 417
- References
- 26
- Citations by year
- 2026: 10 · 2025: 23 · 2024: 17 · 2023: 68 · 2022: 35 · 2021: 41 · 2020: 24 · 2019: 25 · 2018: 25 · 2017: 22 · 2016: 16 · 2015: 24 · 2014: 17 · 2013: 17 · 2012: 15
- FWCI
- 14.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- personality disorders, economic burden, direct medical costs, indirect costs, productivity loss, borderline personality disorder, obsessive-compulsive personality disorder, DSM-IV personality disorders, mental health care costs, treatment-seeking patients, health care reimbursement
- MeSH terms
- Adult, Aged, Analysis of Variance, Female, Humans, Male, Mental Health Services, Middle Aged, Netherlands, Personality Disorders, Surveys and Questionnaires, Regression Analysis, Health Care Costs, Cost of Illness
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