@article{ref1,
title="Excessive mortality and causes of death among patients with personality disorder with comorbid psychiatric disorders",
journal="Social psychiatry and psychiatric epidemiology",
year="2019",
author="Kuo, Chian-Jue and Chen, Wen-Yin and Tsai, Shang-Ying and Chen, Pao-Huan and Ko, Kai-Ting and Chen, Chiao-Chicy",
volume="54",
number="1",
pages="121-130",
abstract="PURPOSE: Excessive mortality has been seen in patients with personality disorder (PD), but it has not been well-studied when patients also have other psychiatric comorbidities. This study investigated the mortality rates and causes of death in an Asian cohort with PD. <br><br>METHOD: We enrolled patients ≥ 18 years of age with PD as defined by DSM-IV criteria (N = 1172), who had been admitted to a psychiatric service center in northern Taiwan between 1985 and 2008. By linking with the national mortality database (1985-2008), cases of mortality (n = 156, 13.3%) were obtained. We calculated the standardized mortality ratios (SMRs) to estimate the mortality gap between patients with PD and the general population. Stratified analyses of mortality rates by Axis I psychiatric comorbidity and sex were performed. <br><br>RESULTS: Borderline PD (n = 391, 33.4%) was the dominant disorder among the subjects. The SMRs for all-cause mortality of PD alone, PD comorbid with non-substance use disorder(non-SUD), and PD comorbid with SUD were 4.46 (95% CI 1.94-6.98), 7.42 (5.99-8.85), and 15.96 (11.07-20.85), respectively. Among the causes of death, the SMR for suicide was the highest (46.92, 95% CI 34.29-59.56). The SMR for suicide in PD patients with comorbid SUD was unusually high (74.23, 95% CI 33.88-114.58). Women had a significant increase in suicide with an SMR of 59.00 (95% CI 37.89-80.11). Men had significant increase in SMRs for cardiovascular disease and gastrointestinal disease. <br><br>CONCLUSIONS: We found significant synergistic effects of PD and SUD on mortality risk. A personality assessment should be mandatory in all clinical settings to prevent premature death and detect SUD early.<p /> <p>Language: en</p>",
language="en",
issn="0933-7954",
doi="10.1007/s00127-018-1587-x",
url="http://dx.doi.org/10.1007/s00127-018-1587-x"
}