Faculty Collaboration Database

Patients with personality disorders: functional status, health care utilization, and satisfaction with care. J Fam Pract 1996 Jan;42(1):54-60

Date

01/01/1996

Pubmed ID

8537806

Scopus ID

2-s2.0-0030058851 (requires institutional sign-in at Scopus site)   57 Citations

Abstract

BACKGROUND: Personality disorders are believed to occur in approximately 10% of the adult population, yet they are rarely diagnosed in primary care settings. This study compares the functional status, health care utilization, and satisfaction with care for patients who were at high risk for a personality disorder with those who were at low risk.

METHODS: Patients at high risk for personality disorders were identified using a standardized psychometric instrument, the Structured Clinical Inventory for DSM-III Axis II (SCID-II). After assigning patients to risk categories, responses were compared on the Medical Outcomes Study Short Form-36, the Beck Depression Inventory, the CAGE alcohol use questionnaire, and an adapted version of the RAND Patient Satisfaction Questionnaire.

RESULTS: Patients who were at high risk for any personality disorder had lower functional status, higher risk for depression or alcohol abuse, and lower levels of satisfaction with care. These differences could not be explained by demographic or socioeconomic differences between high- and low-risk patients. Being at high risk for specific personality disorders, such as borderline, schizoid, and dependent disorders, was associated with higher degrees of functional impairment and greater risk for depression and alcohol abuse. Patients at high risk for other disorders, such as obsessive-compulsive, narcissitic, and schizotypal, consistently showed no appreciable degree of impairment as compared with patients at low risk for any personality disorder. Medical care utilization was no higher when personality disorders were examined in aggregate, but a marked increase in utilization was noted among patients at high risk for histrionic and dependent disorders.

CONCLUSIONS: Among primary care patients, having a personality disorder is associated with lower functional status, lower satisfaction with health care, and higher risk for depression and alcohol abuse.

Author List

Hueston WJ, Mainous AG 3rd, Schilling R

Author

William J. Hueston MD Adjunct Professor in the Family Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Ambulatory Care
Depression
Family Practice
Female
Health Services
Health Status
Humans
Male
Middle Aged
Patient Satisfaction
Personality Disorders
Psychological Tests
Risk
Wisconsin