Abstract
This study aimed to investigate health service utilization among women with mental state disorder only (MSD-PD), mental state disorder plus personality disorder (MSD+PD), and controls in a population-based sample. Women (n = 635) from the Geelong Osteoporosis Study completed mental health assessments and were categorized into groups (MSD-PD, MSD+PD, controls). General practitioner (mental and non-mental health encounters) and specialized mental health service utilization was ascertained from data linkage to the Medicare Benefits Schedule, Australia (01/09/2008-31/12/2012). Negative binomial and binary logistic regression models were employed to assess health service utilization differences between groups. Results indicated that women with MSD+PD had more encounters of non-mental health service utilization than women with MSD-PD and controls. Age significantly modified these relationships: women with MSD+PD and MSD-PD had more encounters of health service utilization at midlife and in the seventh decade of life. No significant differences were found in the frequency of general practitioner mental health service utilization or specialized mental health service utilization between groups. These data suggest that the presence of co-occurring PD is associated with increased health service utilization among women with other common mental health problems. Healthcare providers should be vigilant to the presence of PD when establishing management plans with patients presenting with common mental health problems.
Highlights
METHODSPersonality disorder (PD) is a common disorder, affecting about one-in-eight individuals in the community globally [1]
Two hundred and eleven (33.2%) women met criteria for having a lifetime history of mental state disorder (MSD)-PD, 103 (16.2%) women were identified as having MSD+PD, and 321 (50.6%) women had no history of MSD or PD
In conclusion and with respect to the limitations of the data, this study shows that women with MSD+PD have more frequent encounters of non-mental health service utilization (HSU) than women with MSD-PD or controls without a history of any mental disorder
Summary
METHODSPersonality disorder (PD) is a common disorder, affecting about one-in-eight individuals in the community globally [1]. Individuals with PD and MSD commonly experience co-occurring physical conditions, and this co-occurrence can significantly increase functional disability, poor health outcomes, and health service utilization (HSU) [3]. Both MSDs and PDs have been independently associated with increased HSU, especially emergency department visits and inpatient hospitalizations [4,5,6]. Higher usage of psychosocial and outpatient psychotherapy services, psychotropic medications, and psychiatric hospitalizations has been documented in individuals with PD compared to those with depression [9] It appears that the nature and size of association between MSDs, PD, and HSU remains insufficiently understood
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