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

TY - JOUR

T1 - Defining severity of personality disorder using electronic health records

T2 - Short report

AU - Monk-Cunliffe, Jonathan

AU - Kadra-Scalzo, Giouliana

AU - Finamore, Chloe

AU - Dale, Oliver

AU - Khondoker, Mizanur

AU - Barrett, Barbara

AU - Shetty, Hitesh

AU - Hayes, Richard D.

AU - Moran, Paul

N1 - Publisher Copyright: Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists.

PY - 2023/8/1

Y1 - 2023/8/1

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.

KW - Economics

KW - epidemiology

KW - personality disorders

KW - physical health

KW - rating scales

UR - https://www.scopus.com/pages/publications/85167969626

U2 - 10.1192/bjo.2023.509

DO - 10.1192/bjo.2023.509

M3 - Article

AN - SCOPUS:85167969626

SN - 2056-4724

VL - 9

JO - BJPsych Open

JF - BJPsych Open

IS - 5

M1 - e137

ER -