van Asselt A D I, Dirksen C D, Arntz A, Severens J L
Department of Clinical Epidemiology and MTA, University Hospital Maastricht, Maastricht, The Netherlands.
Eur Psychiatry. 2007 Sep;22(6):354-61. doi: 10.1016/j.eurpsy.2007.04.001. Epub 2007 Jun 4.
Borderline personality disorder (BPD) is a highly prevalent, chronic condition. Because of its very problematic nature BPD is expected to be associated with substantial societal costs, although this has never been comprehensively assessed.
Estimate the societal cost of BPD in the Netherlands.
We used a prevalence-based bottom-up approach with a sample of 88 BPD patients who enrolled in a multicenter clinical trial comparing two kinds of outpatient psychotherapy. Costs were assessed by means of a structured interview, covering all healthcare costs, medication, informal care, productivity losses, and out-of-pocket expenses. Only BPD-related costs were included. All costs were expressed in Euros for the year 2000. A bootstrap procedure was performed to determine statistical uncertainty.
All patients had been diagnosed with BPD using DSM-IV criteria. Mean age was 30.5 years and 92% was female.
Based on a prevalence of 1.1% and an adult population of 11,990,942, we derived that there were 131,900 BPD patients in the Netherlands. Total bootstrapped yearly cost of illness was 2,222,763,789 euros (1,372,412,403-3,260,248,300 euros), only 22% was healthcare-related. Costs per patient were 16,852 euros.
Although healthcare costs of non-institutionalized Borderline patients might not be disproportionate, total societal costs are substantial.
边缘型人格障碍（BPD）是一种高度普遍的慢性疾病。由于其本质上存在诸多问题，预计BPD会带来巨大的社会成本，尽管这从未得到全面评估。
估算荷兰边缘型人格障碍的社会成本。
我们采用基于患病率的自下而上方法，以88名参加比较两种门诊心理治疗的多中心临床试验的BPD患者为样本。通过结构化访谈评估成本，涵盖所有医疗保健成本、药物、非正式护理、生产力损失和自付费用。仅纳入与BPD相关的成本。所有成本均以2000年欧元表示。采用自助法确定统计不确定性。
所有患者均根据《精神疾病诊断与统计手册》第四版（DSM-IV）标准被诊断为BPD。平均年龄为30.5岁，92%为女性。
基于1.1%的患病率和11,990,942名成年人口，我们得出荷兰有131,900名BPD患者。疾病的年度自助总成本为2,222,763,789欧元（1,372,412,403 - 3,260,248,300欧元），其中仅22%与医疗保健相关。每位患者的成本为16,852欧元。
尽管非住院边缘型患者的医疗保健成本可能并不高，但社会总成本却相当可观。
