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 journalArticle (Academic Journal)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 languageEnglish
Article numbere137
JournalBJPsych Open
Volume9
Issue number5
Early online date1 Aug 2023
DOIs
Publication statusPublished - 1 Sept 2023

Bibliographical note

Funding Information:
This paper represents independent research part funded by the NIHR Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. J.M.-C. is part funded by the University of Bristol. C.F. was part funded by the Robert Luff Foundation. R.D.H., G.K.-S. and H.S. receive salary support from the NIHR Biomedical Research Centre at SLaM and King's College London. P.M. is part-funded by the NIHR Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol and by the NIHR Applied Research Collaboration (ARC) West. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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

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