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. 2023 Aug 1;9(5):e137.
doi: 10.1192/bjo.2023.509.

Defining severity of personality disorder using electronic health records: short report

Jonathan Monk-Cunliffe  1 , Giouliana Kadra-Scalzo  2 , Chloe Finamore  3 , Oliver Dale  3 , Mizanur Khondoker  4 , Barbara Barrett  2 , Hitesh Shetty  2 , Richard D Hayes  2 , Paul Moran  1
Affiliations

Defining severity of personality disorder using electronic health records: short report

Jonathan Monk-Cunliffe et al. BJPsych Open. .

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.

Keywords: Economics; epidemiology; personality disorders; physical health; rating scales.

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Conflict of interest statement

R.D.H. has received research funding from Roche, Pfizer, Janssen and Lundbeck. G.K.-S. has received funding from Janssen and Lundbeck.

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