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德国寻求治疗的边缘型人格障碍患者的社会成本。

The societal cost of treatment-seeking patients with borderline personality disorder in Germany.

机构信息

Department of Psychiatry and Psychotherapy, University of Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.

Department of Psychiatry and Psychotherapy, Christian-Albrechts-University Kiel, Kiel, Germany.

出版信息

Eur Arch Psychiatry Clin Neurosci. 2022 Jun;272(4):741-752. doi: 10.1007/s00406-021-01332-1. Epub 2021 Oct 4.

Abstract

According to previous research, borderline personality disorder (BPD) is associated with high cost-of-illness. However, there is still a shortage of cost-of-illness-studies assessing costs from a broad societal perspective, including direct and indirect costs. Further, there are considerable differences in the results among the existing studies. In the present study, 167 German men and women seeking specialized outpatient treatment for BPD were included. We assessed societal cost-of-illness bottom-up through structured face-to-face interviews and encompassed a wide range of cost components. All costs were calculated for the 2015 price level. Cost-of-illness amounted to € 31,130 per patient and year preceding disorder-specific outpatient treatment. € 17,044 (54.8%) were direct costs that were mostly related to hospital treatment. Indirect costs amounted to € 14,086 (45.2%). Within indirect costs, costs related to work disability were the most crucial cost driver. The present study underlines the tremendous economic burden of BPD. According to the present study, both the direct and indirect costs are of significant importance for the societal costs associated with BPD. Besides the need for more disorder-specific treatment facilities for men and women with BPD, we assume that education and employment are topics that should be specifically targeted and individually supported at an early stage of treatment.Trial Registration: German Clinical Trial Registration, DRKS00011534, Date of Registration: 11/01/2017, retrospectively registered.

摘要

根据以往的研究,边缘型人格障碍(BPD)与高疾病负担相关。然而,仍缺乏从广泛的社会视角评估成本的疾病负担研究,包括直接和间接成本。此外,现有研究的结果存在相当大的差异。本研究纳入了 167 名寻求 BPD 专门门诊治疗的德国男女患者。我们通过结构化的面对面访谈自下而上评估了社会疾病负担,涵盖了广泛的成本组成部分。所有成本均按 2015 年的价格水平计算。在接受特定于疾病的门诊治疗之前的一年中,每位患者的疾病负担为 31130 欧元。17044 欧元(54.8%)为直接成本,主要与医院治疗有关。间接成本为 14086 欧元(45.2%)。在间接成本中,与工作能力丧失相关的成本是最重要的成本驱动因素。本研究强调了 BPD 巨大的经济负担。根据本研究,直接和间接成本对于与 BPD 相关的社会成本都具有重要意义。除了需要为 BPD 男女患者提供更多特定于疾病的治疗设施外,我们还假设教育和就业是治疗早期应特别针对和个别支持的主题。试验注册:德国临床试验注册,DRKS00011534,注册日期:2017 年 1 月 11 日,回顾性注册。

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