Burden of Disease of Borderline Personality Disorder: A Comprehensive Evaluation of Quality of Life and Societal Cost of Illness.

Information on the burden of disease, including quality of life (QoL) and societal costs, of borderline personality disorder (BPD) is crucial, as healthcare policymakers consider the burden of disease when setting priorities for treatment reimbursement. We conducted a comprehensive evaluation of the burden of disease of BPD by estimating annual costs from a societal perspective using a bottom-up approach and distinguishing between costs primarily related to psychological and somatic problems. QoL was determined using a generic QoL measure (EQ-5D five-level version [EQ-5D-5L]) as well as a measure specifically designed for individuals with psychological problems (Mental Health Quality of Life seven-dimensional questionnaire [MHQoL-7D]). Additionally, societal costs and QoL were compared with a comparison group. Data from 204 Dutch treatment-seeking outpatients diagnosed with BPD and 86 individuals without severe psychological problems were analyzed. The results indicated a severely impaired QoL (EQ-5D-5L: 0.51, MHQoL-7D: 0.24) combined with substantial societal costs (average total €35,038 per year) for BPD outpatients, markedly different from the comparison group. Societal costs of BPD were primarily attributable to psychological problems, with costs in other sectors as the main cost driver. The BPD group incurred higher costs for most patient and family cost items and cost items in other sectors, whereas differences in healthcare costs were limited to outpatient psychiatric treatment, consultations with general practitioners, emergency care, and social work. The high economic burden, along with the low QoL, suggests that increased treatment reimbursement for BPD would benefit both patients and society at large. Trial Registration: The BOOTS study was registered in the Overview of Medical Research in the Netherlands (NL-OMON21337), formerly known as the Netherlands Trial Register.