Defining severity of personality disorder using electronic health records: Short report

Jonathan Monk-Cunliffe; Giouliana Kadra-Scalzo; Chloe Finamore; Oliver Dale; Mizanur Khondoker; Barbara Barrett; Hitesh Shetty; Richard D. Hayes; Paul Moran

doi:10.1192/bjo.2023.509

Defining severity of personality disorder using electronic health records: Short report

Jonathan Monk-Cunliffe^*, Giouliana Kadra-Scalzo, Chloe Finamore, Oliver Dale, Mizanur Khondoker, Barbara Barrett, Hitesh Shetty, Richard D. Hayes, Paul Moran

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Severity of personality disorder is an important determinant of future health. However, this key prognostic variable is not captured in routine clinical practice. Using a large clinical data-set, we explored the predictive validity of items from the Health of Nation Outcome Scales (HoNOS) as potential indicators of personality disorder severity. For 6912 patients with a personality disorder diagnosis, we examined associations between HoNOS items relating to core personality disorder symptoms (self-harm, difficulty in interpersonal relationships, performance of occupational and social roles, and agitation and aggression) and future health service use. Compared with those with no self-harm problem, the total healthcare cost was 2.74 times higher (95% CI 1.66-4.52; P < 0.001) for individuals with severe to very severe self-harm problems. Other HoNOS items did not demonstrate clear patterns of association with service costs. Self-harm may be a robust indicator of the severity of personality disorder, but further replication work is required.

Original language	English
Article number	e137
Journal	BJPsych Open
Volume	9
Issue number	5
DOIs	https://doi.org/10.1192/bjo.2023.509
Publication status	Published - 1 Aug 2023

Keywords

Economics
epidemiology
personality disorders
physical health
rating scales

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10.1192/bjo.2023.509

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title = "Defining severity of personality disorder using electronic health records: Short report",

abstract = "Severity of personality disorder is an important determinant of future health. However, this key prognostic variable is not captured in routine clinical practice. Using a large clinical data-set, we explored the predictive validity of items from the Health of Nation Outcome Scales (HoNOS) as potential indicators of personality disorder severity. For 6912 patients with a personality disorder diagnosis, we examined associations between HoNOS items relating to core personality disorder symptoms (self-harm, difficulty in interpersonal relationships, performance of occupational and social roles, and agitation and aggression) and future health service use. Compared with those with no self-harm problem, the total healthcare cost was 2.74 times higher (95% CI 1.66-4.52; P < 0.001) for individuals with severe to very severe self-harm problems. Other HoNOS items did not demonstrate clear patterns of association with service costs. Self-harm may be a robust indicator of the severity of personality disorder, but further replication work is required.",

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author = "Jonathan Monk-Cunliffe and Giouliana Kadra-Scalzo and Chloe Finamore and Oliver Dale and Mizanur Khondoker and Barbara Barrett and Hitesh Shetty and Hayes, {Richard D.} and Paul Moran",

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AU - Dale, Oliver

AU - Khondoker, Mizanur

AU - Barrett, Barbara

AU - Shetty, Hitesh

AU - Hayes, Richard D.

AU - Moran, Paul

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N2 - Severity of personality disorder is an important determinant of future health. However, this key prognostic variable is not captured in routine clinical practice. Using a large clinical data-set, we explored the predictive validity of items from the Health of Nation Outcome Scales (HoNOS) as potential indicators of personality disorder severity. For 6912 patients with a personality disorder diagnosis, we examined associations between HoNOS items relating to core personality disorder symptoms (self-harm, difficulty in interpersonal relationships, performance of occupational and social roles, and agitation and aggression) and future health service use. Compared with those with no self-harm problem, the total healthcare cost was 2.74 times higher (95% CI 1.66-4.52; P < 0.001) for individuals with severe to very severe self-harm problems. Other HoNOS items did not demonstrate clear patterns of association with service costs. Self-harm may be a robust indicator of the severity of personality disorder, but further replication work is required.

AB - Severity of personality disorder is an important determinant of future health. However, this key prognostic variable is not captured in routine clinical practice. Using a large clinical data-set, we explored the predictive validity of items from the Health of Nation Outcome Scales (HoNOS) as potential indicators of personality disorder severity. For 6912 patients with a personality disorder diagnosis, we examined associations between HoNOS items relating to core personality disorder symptoms (self-harm, difficulty in interpersonal relationships, performance of occupational and social roles, and agitation and aggression) and future health service use. Compared with those with no self-harm problem, the total healthcare cost was 2.74 times higher (95% CI 1.66-4.52; P < 0.001) for individuals with severe to very severe self-harm problems. Other HoNOS items did not demonstrate clear patterns of association with service costs. Self-harm may be a robust indicator of the severity of personality disorder, but further replication work is required.

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KW - rating scales

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Defining severity of personality disorder using electronic health records: Short report

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Keywords

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