General hospital admission rates in people diagnosed with personality disorder

Objective: To determine the frequency of all-cause general hospital admissions for individuals with personality disorder (PD) in a large clinical population using linked secondary mental healthcare and hospitalisation data.

Method: A retrospective cohort study, using anonymised electronic mental health records from South London and Maudsley NHS Foundation Trust (SLaM), linked to Hospital Episodes Statistics in England. People with PD aged 15 years or older, receiving care within SLaM between April 2007 and March 2013, were identified and compared to residents from the local catchment area. Standardised admission ratios (SARs) were calculated for all major categories of causes of general hospital admission for this defined group, with local residents in 2011 UK Census as the standard population.

Results: For the 7,677 people identified with PD, SAR for all causes of admission was 2.75 (95% CI: 2.70, 2.81). Both men and women with PD had increased SARs across multiple ICD-10 categories, including circulatory, respiratory, digestive, nervous, and musculoskeletal system disorders, and endocrine, blood and infectious disorders. Sensitivity analysis (removing the impact of repeated admissions by same individual for same diagnosis in the same year) yielded similar findings.

Conclusions: By comparison with members of the general population, individuals with a diagnosis of personality disorder are at significantly higher risk of hospital admission resulting from a wide range of physical health problems.