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Personality disorders, common mental disorders and receipt of disability benefits: evidence from the British National Survey of Psychiatric Morbidity

Published online by Cambridge University Press:  08 May 2012

A. K. Knudsen ,
J. C. Skogen ,
S. B. Harvey ,
R. Stewart ,
M. Hotopf  and
P. Moran
A. K. Knudsen*
Affiliation:
University of Bergen, Department of Health Promotion and Development, Faculty of Psychology, Bergen, Norway Norwegian Institute of Public Health, Department of Public Mental Health, Division of Mental Health, Bergen, Norway
J. C. Skogen
Affiliation:
University of Bergen, Department of Health Promotion and Development, Faculty of Psychology, Bergen, Norway Norwegian Institute of Public Health, Department of Public Mental Health, Division of Mental Health, Bergen, Norway
S. B. Harvey
Affiliation:
University of New South Wales, School of Psychiatry, Australia King's College London, Institute of Psychiatry, London, UK
R. Stewart
Affiliation:
King's College London, Institute of Psychiatry, London, UK
M. Hotopf
Affiliation:
King's College London, Institute of Psychiatry, London, UK
P. Moran
Affiliation:
King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: A. K. Knudsen, Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Christiesgate 13, N-5020 Bergen, Norway. (Email: Ann.Knudsen@psych.uib.no)
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Abstract

Background

Common mental disorders (CMDs) are associated with occupational impairment and the receipt of disability benefits (DBs). Little is known about the relationship between personality disorders (PDs) and work disability, and whether the association between CMDs and work disability is affected by the presence of co-morbid PDs. The aim of this study was to examine the association between DB and individual categories of PDs, with special attention to the effect of co-morbid CMDs on this association.

Method

The association between DB and PD was examined using data from the 2000 British National Survey of Psychiatric Morbidity. Probable PD caseness was identified using the Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II) screening questionnaire. The impact of CMDs, assessed with the revised version of the Clinical Interview Schedule (CIS-R), was examined as a covariate and in a stratified analysis of co-morbidity. Other covariates included sociodemographic factors, long-standing illnesses and substance use.

Results

Probable PD was associated with DB, with the strongest associations found for borderline, dependent and schizotypal PD. Antisocial PD was not associated with DB. The relationship between PD and DB was strongly modified by CMD, reducing the association from an odds ratio (OR) of 2.84 to 1.34 [95% confidence interval (CI) 1.00–1.79)]. In the stratified analysis, co-morbid PD and CMD showed a stronger association with DB than PD without CMD but, when fully adjusted, this effect was not significantly different from the association between CMD without PD.

Conclusions

Individuals screening positive for PD are more likely to experience severe occupational outcomes, especially in the presence of co-morbid CMD.

Keywords

Common mental disordersemploymentpersonalitypersonality disorderspopulation surveyworkwork disability
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 12 , December 2012 , pp. 2631 - 2640
Copyright
Copyright © Cambridge University Press 2012

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