Is borderline personality disorder only a mental health problem?

Area of Science:

• Psychiatry
• Health Services Research
• Medical Economics

Background:

• Borderline personality disorder (BPD) is associated with increased healthcare utilization.
• Understanding the physical health service use in BPD is crucial for resource allocation and patient care.

Purpose of the Study:

• To compare physical health service utilization between patients with severe BPD, other personality disorders (PDs), and a general population control group.
• To estimate the healthcare costs associated with BPD, focusing on somatic care.

Main Methods:

• A multicentre study utilizing a 5-year insurance database.
• Comparison of healthcare utilization metrics (prescriptions, consultations, hospitalizations) across three groups: severe BPD (n=36), other PDs (n=38), and general population controls (n=165).

Main Results:

• The BPD group showed significantly higher mean medication prescriptions (377.3 vs. 97.4), general medical consultations (34.4 vs. 13.2), and hospitalization days (10.2 vs. 1.9) compared to the general population.
• No significant differences in service utilization were found between the BPD and other PD groups.
• Annual healthcare cost per BPD patient estimated at €12,761, with 17.6% attributed to somatic care.
• Comorbidity with narcissistic PD (NPD) correlated with increased medication and hospitalization use in the BPD group.

Conclusions:

• Borderline personality disorder imposes a significant medical burden, extending beyond psychiatric symptoms.
• BPD patients require more extensive physical healthcare resources, highlighting the need for integrated care approaches.
• The findings underscore the importance of considering somatic health in the comprehensive management of BPD.