title: Personality disorders and physical health: a longitudinal examination of physical functioning, healthcare utilization, and health-related behaviors in middle-aged adults.
abstract: Personality disorders (PDs) have significant, long-term effects in many areas, including physical health outcomes such as increased risk for chronic disease and mortality. Although research has documented this detrimental impact in relation to long-term physical health, no one has explored the more immediate influence of disordered personality on aspects of physical functioning, such as pain level, or health-related behaviors, such as medication use. The present study examined the unique effects of PD features on physical functioning, medical resource utilization, and prescription medication use to determine potential risk associated with PDs. We studied an epidemiologically-based sample (N = 608) of Saint Louis residents (ages 55-64) over two time points (6 months apart). We found that disordered personality was significantly predictive of worse physical functioning, role limitations, fatigue, and pain at both time points, even when current health problems, the presence of depression, and health behaviors (i.e., smoking, drinking, exercise) were controlled. PD features were also predictive of increased healthcare utilization and medication use at follow-up. These results suggest that the presence of disordered personality may be an important risk factor for worse functioning, regardless of actual health status.
authors.affiliation: Department of Psychology, Washington University, 1 Brookings Drive, Campus Box 1125, St. Louis, MO 63130, USA.
authors.forename: Abigail D
authors.initials: AD
authors.lastname: Powers
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Oltmanns
mesh_terms: D000203:Activities of Daily Living; D000428:Alcohol Drinking / Q000453:epidemiology; D001294:Attitude to Health; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology; D015444:Exercise; D005221:Fatigue; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D010554:Personality Disorders / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology