Treatment utilization by patients with personality disorders

Objective: Utilization of mental health treatment was compared in patients with personality disorders and patients with major depressive disorder with out personality disorder. Method: Semistructured interviews were used to assess diagnosis and treatme nt history of 664 patients in four representative personality disorder grou ps-schizotypal, borderline, avoidant, and obsessive-compulsive-and in a com parison group of patients with major depressive disorder. Results: Patients with personality disorders had more extensive histories o f psychiatric outpatient, inpatient, and psychopharmacologic treatment than patients with major depressive disorder. Compared to the depression group, patients with borderline personality disorder were significantly more like ly to have received every type of psychosocial treatment except self-help g roups, and patients with obsessive-compulsive personality disorder reported greater utilization of individual psychotherapy. Patients with borderline personality disorder were also more likely to have used antianxiety, antide pressant, and mood stabilizer medications, and those with borderline or sch izotypal personality disorder had a greater likelihood of having received a ntipsychotic medications. Patients with borderline personality disorder had received greater amounts of treatment, except for family/couples therapy a nd self-help, than the depressed patients and patients with other personali ty disorders. Conclusions: These results underscore the importance of considering persona lity disorders in diagnosis and treatment of psychiatric patients. Borderli ne and schizotypal personality disorder are associated with extensive use o f mental health resources, and other, less severe personality disorders may not be addressed sufficiently in treatment planning. More work is needed t o determine whether patients with personality disorders are receiving adequ ate and appropriate mental health treatments.