Welfare consequences of early-onset Borderline Personality Disorder: a nationwide register-based case-control study
Welfare consequences of early-onset Borderline Personality Disorder: a nationwide register-based case-control study
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DOI：
10.1007/s00787-020-01683-5
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发表时间：
2020-11-24
影响因子：
6.4
通讯作者：
Simonsen, Erik
中科院分区：
文献类型：
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作者：
Hastrup, Lene Halling;Jennum, Poul;Simonsen, Erik
关于早期发作的边缘型人格障碍（BPD）的福利后果的信息是有限的。这项全国性的研究旨在评估早发性BPD患者与匹配对照组相比的教育和就业结果以及医疗保健费用。纳入了1983-2015年期间丹麦患者登记册（NPR）中首次诊断为BPD的所有患者（< 19岁）。卫生保健费用和社会经济变量从国家登记册中提取。共有171名患者与677名对照进行了比较。在20岁时，与对照组相比，BPD患者的教育水平（包括小学低年级）和就业状况在统计学上显着降低。当调整父母的教育水平时，BPD患者失业的可能性是对照组的近22倍（OR = 21.7，95%CI 11.9，39.6），领取残疾养老金的可能性是对照组的近15倍（OR = 14.8，95%CI 5.0，43.9）。此外，BPD组的总医疗费用高出8倍以上。早在20岁时，BPD的早期发作与较低的教育和职业结果以及增加的医疗保健费用有关。即使在控制了父母较低的社会经济地位后，患者的结局也比对照组差。这突出表明，非常需要采取措施支持患者完成学校和中学教育。未来的预防和早期干预计划应针对早发性BPD患者及其家人。
Information regarding welfare consequences of early onset of Borderline Personality Disorder (BPD) is limited. This nationwide study aimed to estimate the educational and employment outcome and health care costs of patients with early-onset BPD compared with matched controls. All patients (< 19 years) with first diagnosis of BPD in the Danish Patient Register (NPR) during the period 1983-2015 were included. Health care costs and socioeconomic variables were extracted from national registers. A total of 171 patients was compared with 677 controls. At the age of 20 years, BPD patients had reached a statistically significantly lower educational level (including lower primary school grades) and employment status compared with the controls. When adjusting for the parents' educational level, BPD patients were nearly 22 times more likely to be unemployed (OR = 21.7, 95% CI 11.9, 39.6), and nearly 15 times more likely to be on disability pension (OR = 14.8, 95% CI 5.0, 43.9) than controls. Furthermore, the total health care costs were more than 8 times higher in the BPD group. Early onset of BPD was associated with lower educational and vocational outcome and increased health care costs as early as at the age of 20 years. Even after controlling for parents' lower socioeconomic status, the patients have poorer outcome than the control group. This underlines that initiatives to support patients in finishing school and secondary education is highly needed. Future prevention and early intervention programs should target patients with early-onset BPD and their families.