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The British Journal of Psychiatry (2002) 181: 62-66
© 2002 The Royal College of Psychiatrists

Economic impact of personality disorders in UK primary care attenders

ALISON RENDU, BA

Centre for the Economics of Mental Health

PAUL MORAN, MRCPsych

Health Services Research Department

ANITA PATEL, MSc

Centre for the Economics of Mental Health, Institute of Psychiatry, London

MARTIN KNAPP, PhD

Centre for the Economics of Mental Health, Institute of Psychiatry; and PSSRU, London School of Economics, UK

ANTHONY MANN, FRCPsych

Section of Epidemiology, Institute of Psychiatry, London

Correspondence: Paul Moran, Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Tel: 020 7848 0568; fax: 020 7848 0333; e-mail: paul.moran{at}iop.kcl.ac.uk

Declaration of interest This study was supported by grants from the Medical Research Council and the Department of Health.

Background The economic impact of personality disorders on UK health services is unknown.

Aims To test the hypothesis that people with personality disorders have higher mean health and non-health costs compared with those without personality disorders.

Method Prospective cohort study design. A total of 303 general practice attenders were followed-up I year after they had been assessed for the presence of personality disorders. Costs were estimated in £ sterling at 1999 price levels.

Results The mean total cost for patients with personality disorders was £3094 (s.d.=5324) compared with £1633 (s.d.=3779) for those without personality disorders. Personality disorders were not independently associated with increased costs. Multivariate analyses identified the presence of a significant interaction between personality disorders and common mental disorders and increased total costs (coefficient=499, 95% CI 180.1-626.2, P=0.002).

Conclusions Personality disorders are not independently associated with increased costs. An interaction between personality disorders and common mental disorders significantly predicts increased total costs.


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