Study of personality disorders and the use of services in the clinical population attended in the mental health network of a community area

Abstract

Introduction. Personality disorders (PD) are a growing clinical and health care problem. In Spain, the studies of PD and utilization of the Mental Health Services (MHS) in the clinical population are scant. However, these data are necessary in the planning of MHS for PD.

Method. We studied all the patients attended throughout one year in all the psychiatric departments (n=2701), and separately in the inpatient (n=193) and outpatient (n= 2649) psychiatric services. All the patients diagnosed with PD by clinical interview (DSM-IV-TR Criteria) were included. Demographic and clinical variables as well as use of MHS were studied.

Results. The proportion of PD in the population attended was 11% (95% CI: 9.8%-12.2%) and in the inpatient and outpatient psychiatric services 17.6% (95% CI: 12.9%-23.6%) and 10.3% (95% CI: 9.2%-11.5%), respectively. The most representative PD were borderline (25.7%), histrionic (24%) and obsessive-compulsive (6.4%) and 19.6% were Not Otherwise Specified PD. PD accounted for an extensive use of mental health resources (inpatient, outpatient and emergency units). The most comorbid conditions in axis I were affective, anxiety and substance-related disorders.

Conclusions. The study of PD attended in the MHS in a community area by means of clinical evaluation is an economical instrument, which is easily applied and replicated in planning of MHS for PD.