Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T04:41:30.377Z Has data issue: false hasContentIssue false

Physical health comorbidities in women with personality disorder: Data from the Geelong Osteoporosis Study

Published online by Cambridge University Press:  23 March 2020

SE Quirk*
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia
AL Stuart
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia
SL Brennan-Olsen
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia Institute of Health and Ageing, Australian Catholic University, Melbourne, Australia
JA Pasco
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia Melbourne Medical School-Western Campus, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia
M Berk
Affiliation:
Department of Psychiatry, University of Melbourne, Melbourne, Australia Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia & Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Australia Florey Institute for Neuroscience and Mental Health, Melbourne, Melbourne, Australia
AM Chanen
Affiliation:
Orygen, the National Centre of Excellence in Youth Mental Health, Melbourne, Australia & Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
H Koivumaa-Honkanen
Affiliation:
Institute of Clinical Medicine, Psychiatry, University of Eastern Finland (UEF), Kuopio, Finland Departments of Psychiatry, Kuopio University Hospital, Kuopio; South-Savonia Hospital District, Mikkeli; North Karelia Central Hospital, Joensuu; SOSTERI, Savonlinna; SOTE, Iisalmi; Lapland Hospital District, Rovaniemi, Finland Clinic of Child Psychiatry, University Hospital of Oulu, Oulu, Finland
MA Kotowicz
Affiliation:
Melbourne Medical School-Western Campus, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia School of Medicine, Deakin University, Geelong, Australia
PS Lukkala
Affiliation:
School of Medicine, Faculty of Health Sciences, UEF, Kuopio, Finland Bone and Cartilage Research Unit, Surgery, Institute of Clinical Medicine, UEF, Kuopio, Finland
LJ Williams
Affiliation:
Deakin University, IMPACT Strategic Research Centre, School of Medicine, Geelong, Australia
*
*Corresponding author. Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, PO box 281, Ryrie Street, Geelong VIC 3220, Australia. Tel.: +61 405250358. E-mail address:[email protected] (S.E. Quirk).
Get access

Abstract

Background

Associations between common psychiatric disorders, psychotic disorders and physical health comorbidities are frequently investigated. The complex relationship between personality disorders (PDs) and physical health is less understood, and findings to date are varied. This study aims to investigate associations between PDs with a number of prevalent physical health conditions.

Methods

This study examined data collected from women (n = 765; ≥ 25 years) participating in a population-based study located in south-eastern Australia. Lifetime history of psychiatric disorders was assessed using the semi-structured clinical interviews (SCID-I/NP and SCID-II). The presence of physical health conditions (lifetime) were identified via a combination of self-report, medical records, medication use and clinical data. Socioeconomic status, and information regarding medication use, lifestyle behaviors, and sociodemographic information was collected via questionnaires. Logistic regression models were used to investigate associations.

Results

After adjustment for sociodemographic variables (age, socioeconomic status) and health-related factors (body mass index, physical activity, smoking, psychotropic medication use), PDs were consistently associated with a range of physical health conditions. Novel associations were observed between Cluster A PDs and gastro-oesophageal reflux disease (GORD); Cluster B PDs with syncope and seizures, as well as arthritis; and Cluster C PDs with GORD and recurrent headaches.

Conclusions

PDs were associated with physical comorbidity. The current data contribute to a growing evidence base demonstrating associations between PDs and a number of physical health conditions independent of psychiatric comorbidity, sociodemographic and lifestyle factors. Longitudinal studies are now required to investigate causal pathways, as are studies determining pathological mechanisms.

Type
Original article
Copyright
Copyright © European Psychiatry 2016

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

El-Gabalawy, RKatz, LYSareen, JComorbidity and associated severity of borderline personality disorder and physical health conditions in a nationally representative sample. Psychosom Med 2010;72: 641647.CrossRefGoogle Scholar
Lee, HBBienvenu, OJCho, S.-J.Ramsey, CMBandeen-Roche, KEaton, WWet al.Personality disorders and traits as predictors of incident cardiovascular disease: findings from the 23-year follow-up of the Baltimore ECA study. Psychosomatics 2010;51: 289296.CrossRefGoogle ScholarPubMed
Moran, PStewart, RBrugha, TBebbington, PBhugra, DJenkins, Ret al.Personality disorder and cardiovascular disease: results from a national household survey. J Clin Psychiatry 2007;68: 6974.CrossRefGoogle ScholarPubMed
Quirk, SEEl-Gabalawy, RBrennan, SLBolton, JMSareen, JBerk, Met al.Personality disorders and physical comorbidities in adults from the United States: data from the National Epidemiologic Survey on Alcohol and Related Conditions. Soc Psychiatry Psychiatr Epidemiol 2015;50: 807820.CrossRefGoogle ScholarPubMed
McWilliams, LAClara, IPMurphy, PDCox, BJSareen, JAssociations between arthritis and a broad range of psychiatric disorders: findings from a nationally representative sample. J Pain 2008;9: 3744.CrossRefGoogle Scholar
Goldstein, RBDawson, DAChou, SPRuan, WJSaha, TDPickering, RPet al.Antisocial behavioral syndromes and past-year physical health among adults in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions. J Clin Psychiatry 2008;69: 368380.CrossRefGoogle ScholarPubMed
Afifi, TOMota, NMacMillan, HLSareen, JHarsh physical punishment in childhood and adult physical health. Pediatrics 132 2013 e333e340.CrossRefGoogle ScholarPubMed
Chanen, AMJovev, MJackson, HJAdaptive functioning and psychiatric symptoms in adolescents with borderline personality disorder. J Clin Psychiatry 2007;68: 297306.CrossRefGoogle ScholarPubMed
Skodol, AEGrilo, CMPagano, MEBender, DSGunderson, JGShea, MTet al.Effects of personality disorders on functioning and well-being in major depressive disorder. J Psychiatr Pract 2005;11: 363368.CrossRefGoogle ScholarPubMed
Kiecolt-Glaser, JKMcGuire, LRobles, TFGlaser, REmotions, morbidity, and mortality: new perspectives from psychoneuroimmunology. Annu Rev Psychol 2002;53: 83107.CrossRefGoogle ScholarPubMed
Streeck-Fischer, Avan der Kolk, BADown will come baby, cradle and all: diagnostic and therapeutic implications of chronic trauma on child development. ANZJP 2000;34: 903918.Google ScholarPubMed
Rendu, AMoran, PPatel, AKnapp, MMann, AEconomic impact of personality disorders in UK primary care attenders. Br J Psychiatry 2002;181: 6266.CrossRefGoogle ScholarPubMed
Quirk, SEBerk, MChanen, AM, Koivumaa-Honkanen, H, Brennan-Olsen, SL, Pasco, JA, et al. Population prevalence of personality disorder and associations with physical health comorbidities and health care service utilization: A review. Personal Disord (published online ahead of print).Google Scholar
Samuels, JPersonality disorders: epidemiology and public health issues. Int Rev Psychiatry 2011;23: 223233.CrossRefGoogle ScholarPubMed
Jackson, HJBurgess, PMPersonality disorders in the community: results from the Australian National Survey of Mental Health and Wellbeing Part II. Relationships between personality disorder. Axis I mental disorders and physical conditions with disability and health consultations. Soc Psychiatry Psychiatr Epidemiol 2002;37: 251260.CrossRefGoogle ScholarPubMed
Gunderson, JGStout, RLMcGlashan, THShea, MTMorey, LCGrilo, CMet al.Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study. Arch Gen Psychiatry 2011;68: 827837.CrossRefGoogle ScholarPubMed
Quirk, SE, Berk, M, Pasco, JA, Brennan-Olsen, SL, Chanen, A, Koivumaa-Honkanen, H, et al. Prevalence, age distribution and comorbidity of personality disorders in a sample of Australian women. ANZJP (provisional acceptance).Google Scholar
Trull, TJJahng, STomko, RLWood, PKSher, KJRevised NESARC personality disorder diagnoses: gender, prevalence, and comorbidity with substance dependence disorders. J Pers Disord 2010;24: 412426.CrossRefGoogle ScholarPubMed
World Health Organization Global Burden of Disease 2004 update Geneva; 2008.Google Scholar
Sanna, LStuart, ALBerk, MPasco, JAGirardi, PWilliams, LJGastro oesophageal reflux disease (GORD)-related symptoms and its association with mood and anxiety disorders and psychological symptomology: a population-based study in women. BMC Psychiatry 13 2013 194CrossRefGoogle ScholarPubMed
Sanna, LStuart, ALPasco, JAKotowicz, MABerk, MGirardi, Pet al.Physical comorbidities in men with mood and anxiety disorders: a population-based study. BMC Med 11 2013 110CrossRefGoogle ScholarPubMed
El-Gabalawy, RMackenzie, CSPietrzak, RHSareen, JA longitudinal examination of anxiety disorders and physical health conditions in a nationally representative sample of U.S. older adults. Exp Gerontol 2014;60: 4656.CrossRefGoogle Scholar
Moreno, CNuevo, RChatterji, SVerdes, EArango, CAyuso-Mateos, JLPsychotic symptoms are associated with physical health problems independently of a mental disorder diagnosis: results from the WHO World Health Survey. World Psychiatry 2013;12: 251257.CrossRefGoogle ScholarPubMed
Nuevo, RChatterji, SFraguas, DVerdes, ENaidoo, NArango, Cet al.Increased risk of diabetes mellitus among persons with psychotic symptoms: results from the WHO World Health Survey. J Clin Psychiatry 2011;72: 15921599.CrossRefGoogle ScholarPubMed
Partti, KVasankari, TKanervisto, MPerala, JSaarni, SIJousilahti, Pet al.Lung function and respiratory diseases in people with psychosis: population-based study. Br J Psychiatry 2015;207: 3745.CrossRefGoogle ScholarPubMed
Van der Kooy, Kvan Hout, HMarwijk, HMarten, HStehouwer, CBeekman, ADepression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry 2007;22: 613626.CrossRefGoogle ScholarPubMed
Pasco, JANicholson, GCKotowicz, MACohort profile: Geelong Osteoporosis Study. Int J Epidemiol 2012;41: 15651575.CrossRefGoogle ScholarPubMed
First, MSpitzer, RGibbon, MWilliams, JStructured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version. Non-patient Edition. (SCID-I/NP) New York: New York State Psychiatric Institute, Biometrics Research; 2002.Google Scholar
First, MGibbon, MSpitzer, RWilliams, JBenjamin, LStructured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) Washington, D.C: American Psychiatric Press, Inc; 1997.Google Scholar
Brennan, SLHenry, MJWluka, AENicholson, GCKotowicz, MAWilliams, JWet al.BMD in population-based adult women is associated with socioeconomic status. J Bone Miner Res 2009;24: 809815.CrossRefGoogle ScholarPubMed
Williams, LJBrennan, SLHenry, MJBerk, MJacka, FNNicholson, GCet al.Area-based socioeconomic status and mood disorders: cross-sectional evidence from a cohort of randomly selected adult women. Maturitas 2011;69: 173178.CrossRefGoogle ScholarPubMed
Jansson, CNordenstedt, HWallander, MAJohansson, SJohnsen, RHveem, Ket al.Severe gastro-oesophageal reflux symptoms in relation to anxiety, depression and coping in a population-based study. Aliment Pharmacol Ther 2007;26: 683691.CrossRefGoogle ScholarPubMed
World Health Organization, Diagnostic and statistical manual of mental disorders 4th ed. 2000 Washington, DC [text rev.]Google Scholar
Silberstein, SDLipton, RBBreslau, NMigraine: association with personality characteristics and psychopathology. Cephalalgia 1995;15: 358369.CrossRefGoogle ScholarPubMed
Biskin, RSFrankenburg, FRFitzmaurice, GMZanarini, MCPain in patients with borderline personality disorder. Personal Ment Health 2014;8: 218227.CrossRefGoogle ScholarPubMed
Powers, ADOltmanns, TFBorderline personality pathology and chronic health problems in later adulthood: the mediating role of obesity. Personal Disord 2013;4: 152159.CrossRefGoogle ScholarPubMed
Kahl, KGGreggersen, WRudolf, SStoeckelhuber, BMBergmann-Koester, CUDibbelt, Let al.Bone mineral density, bone turnover, and osteoprotegerin in depressed women with and without borderline personality disorder. Psychosom Med 2006;68: 669674.CrossRefGoogle ScholarPubMed
Butler, CZeman, AZNeurological syndromes which can be mistaken for psychiatric conditions. J Neurol Neurosurg Psychiatr 2005;76(Suppl. 1):i31i38.CrossRefGoogle ScholarPubMed
Frankenburg, FRZanarini, MRelationship between cumulative BMI and symptomatic, psychosocial, and medical outcomes in patients with borderline personality disorder. J Pers Disord 2011;25: 421431.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.