Soc Psychiatry Psychiatr Epidemiol. 2014 Feb;49(2):307-16. doi: 10.1007/s00127-013-0746-3.
Patients with a diagnosis of personality disorder (PD) have multiple and diverse needs. It has been noted that individuals with personality disorder are high users of health care resources, especially psychiatric services, ambulance services and emergency departments. In addition PD has been shown to be a significant predictor of disability and mental health consultations independent of Axis I disorders and physical conditions. This study aimed to compare the patterns of service usage, clinical ratings of symptoms and functioning, as well as demographic and clinically relevant historical variables between a group of patients with PD and a random sample of all other patients registered with a South London Community Mental Health Team.
A case–control design was used to examine service usage patterns over a one-year period for 73 cases and 96 controls. Diagnoses were established by clinician discussion. Clinical outcomes were measured with Health of the Nation Outcome Scales and Global Assessment of Functioning, while service use was recorded using ten variables obtained from case note review.
People with a diagnosis of PD were more often white and had a history of abuse, particularly childhood emotional abuse. They were higher users of some aspects of the service as compared to controls, and had significantly higher severity of symptoms and poorer functioning on clinician-rated measures.
This study confirms previous findings that people with PD have more severe symptomatology and greater degrees of functional impairment when compared to those without. Community clinicians should routinely screen attenders to predict likely difficulties that might arise and to make provision for these difficulties in the treatment and management of clients.
患有人格障碍（PD）诊断的患者有多种不同的需求。已经注意到，人格障碍患者是医疗保健资源的大量使用者，特别是精神科服务、救护车服务和急诊部门。此外，PD 已被证明是残疾和心理健康咨询的一个重要预测因素，独立于轴 I 障碍和身体状况。本研究旨在比较一组 PD 患者和伦敦南部社区心理健康团队所有其他注册患者的随机样本之间的服务使用模式、症状和功能的临床评估，以及人口统计学和临床相关历史变量。
使用病例对照设计，在一年内对 73 例病例和 96 例对照进行服务使用模式检查。通过临床医生讨论确定诊断。使用健康国家结局量表和总体功能评估来衡量临床结果，而服务使用则通过从病例记录中获取的十个变量进行记录。
与对照组相比，PD 诊断患者更常为白人，并有过虐待史，尤其是童年情感虐待史。与对照组相比，他们对某些方面的服务使用更多，并且在临床医生评定的测量中症状严重程度更高，功能更差。
本研究证实了先前的发现，即与没有 PD 的人相比，PD 患者的症状更严重，功能障碍程度更大。社区临床医生应定期对就诊者进行筛查，以预测可能出现的困难，并为治疗和管理患者时出现的这些困难做好准备。
