The epidemiology and clinical features of personality disorders in later life; a study of secondary care data

Treagust, Natasha; Sidhom, Emad; Lewis, J. D.; Denman, Chess; Knutson, Olivia; Underwood, Benjamin R.

doi:10.1002/gps.5837

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…Generally, those with the higher risk were individuals in the 50-64 years groups, but it was possible to identify a trend for anxiolytics, with an increased risk with increasing age. In a recent study on patients with cluster B PDs, the authors found that older individuals were more likely to use many medications (more elevated than those <65 years) and significantly higher than their peers without cluster B PD diagnosis (62). A cluster B PD diagnosis seems to be a risk factor for receiving many medications, more so than for patients with other psychiatric diagnoses, such as affective disorders (62).…”

Section: Discussionmentioning

confidence: 97%

Psychotropic medication use pre and post-diagnosis of cluster B personality disorder: a Quebec’s health services register cohort

Lunghi,

Cailhol,

Massamba

et al. 2023

Front. Psychiatry

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BackgroundCluster B personality disorders (PDs) are considered some of the most severe mental health conditions. Scarce evidence exists about the real-world utilization of psychotropics for cluster B PD individuals.ObjectiveWe aimed to uncover trends and patterns of psychotropic medication use among individuals diagnosed with cluster B PD in the year before and after their diagnosis and to identify factors associated with medication use in a large cohort of individuals newly diagnosed with cluster B PDs.MethodsWe conducted a population-based observational study using Quebec’s health services register. We identified Quebec residents aged ≥14 years and insured with the provincial drug plan with a first diagnosis of cluster B PD recorded between April 1, 2002, and March 31, 2019. Cluster B PD was defined with ICD-9/10 diagnostic codes. We retrieved all claims for the main psychotropic medication classes: antipsychotics, antidepressants, anxiolytics, mood stabilizers, and attention-deficit/hyperactivity disorder (ADHD) medications. We calculated the proportion of individuals exposed to these medication classes and analyzed trends over the years using robust Poisson regression models, adjusting for potential confounders. We used robust Poisson regression to identify factors associated with medication class use.ResultsWe identified 87,778 new cases of cluster B PD, with a mean age of 44.5 years; 57.5% were women. Most frequent psychiatric comorbidities in the five years before cluster B PD diagnosis were depression (50.9%), anxiety (49.7%), and psychotic disorders (37.5%). Most individuals (71.0%) received at least one psychotropic during the year before cluster B PD diagnosis, and 78.5% received at least one of these medications in the subsequent year. The proportion of users increased after the diagnosis for antidepressants (51.6–54.7%), antipsychotics (35.9–45.2%), mood stabilizers (14.8–17.0%), and ADHD medications (5.1–5.9%), and remained relatively stable for anxiolytics (41.4–41.7%). Trends over time showed statistically significant increased use of antipsychotics and ADHD medications, decreased use of anxiolytics and mood stabilizers, and a stable use of antidepressants.ConclusionPsychotropic medication use is highly prevalent among cluster B PD individuals. We observed an increase in medication use in the months following the diagnosis, particularly for antipsychotics, antidepressants, and mood stabilizers.

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Section: Discussionmentioning

confidence: 97%

Psychotropic medication use pre and post-diagnosis of cluster B personality disorder: a Quebec’s health services register cohort

Lunghi,

Cailhol,

Massamba

et al. 2023

Front. Psychiatry

View full text Add to dashboard Cite

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The epidemiology and clinical features of personality disorders in later life; a study of secondary care data

Treagust

Sidhom

Lewis

et al. 2022

Int J Geriat Psychiatry

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Objectives: Personality disorders (PDs) are often conceptualised as impacting individuals throughout their life. However, there has been limited study of the disorders in those over the age of 65. We have used the psychiatric secondary care medical records of 21,971 individuals over the age of 65 from Cambridgeshire, UK, who received care between 2014 and 2021 to characterise older patients with a PD diagnosis. Methods:The data from all patients >65 with a diagnosis of personality disorder (PD) was extracted (n = 217) along with two comparison groups (n = 2170); patients <65 with a diagnosis of PD and patients >65 with a psychiatric diagnosis other than PD or dementia.Results: Compared to younger patients with PD, older patients were more likely to be male, married, suffering from a mixed PD and live in less deprived areas.Compared to patients >65 with diagnoses other than PD, older patients were more likely to be female, single or divorced and had a higher level of social deprivation.Our most striking finding was that older patients with PDs were more likely to experience polypharmacy. A mean of 18.48 different drugs had been prescribed over their lifetime, compared to 9.51 for patients >65 with other mental health diagnoses. Conclusion:Here we present the largest ever description of this group of patients and provide insights that could inform clinical practice and future research.

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The epidemiology and clinical features of personality disorders in later life; a study of secondary care data

Cited by 2 publications

References 15 publications

Psychotropic medication use pre and post-diagnosis of cluster B personality disorder: a Quebec’s health services register cohort

Psychotropic medication use pre and post-diagnosis of cluster B personality disorder: a Quebec’s health services register cohort

The epidemiology and clinical features of personality disorders in later life; a study of secondary care data

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