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The cost of borderline personality disorder: societal cost of illness in BPD-patients

Published online by Cambridge University Press:  04 June 2007

A.D.I. van Asselt*
Department of Clinical Epidemiology and MTA, University Hospital Maastricht, Maastricht, The Netherlands
C.D. Dirksen
Department of Clinical Epidemiology and MTA, University Hospital Maastricht, Maastricht, The Netherlands
A. Arntz
Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
J.L. Severens
Department of Clinical Epidemiology and MTA, University Hospital Maastricht, Maastricht, The Netherlands Department of Health Organization, Policy, and Economics (HOPE), Maastricht University, Maastricht, The Netherlands
Corresponding author. Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands. Tel.: +31 43 3875587; fax: +31 43 3874419. E-mail address: (A.D.I. van Asselt).
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Borderline personality disorder (BPD) is a highly prevalent, chronic condition. Because of its very problematic nature BPD is expected to be associated with substantial societal costs, although this has never been comprehensively assessed.


Estimate the societal cost of BPD in the Netherlands.

Study Design

We used a prevalence-based bottom-up approach with a sample of 88 BPD patients who enrolled in a multicenter clinical trial comparing two kinds of outpatient psychotherapy. Costs were assessed by means of a structured interview, covering all healthcare costs, medication, informal care, productivity losses, and out-of-pocket expenses. Only BPD-related costs were included. All costs were expressed in Euros for the year 2000. A bootstrap procedure was performed to determine statistical uncertainty.


All patients had been diagnosed with BPD using DSM-IV criteria. Mean age was 30.5 years and 92% was female.


Based on a prevalence of 1.1% and an adult population of 11,990,942, we derived that there were 131,900 BPD patients in the Netherlands. Total bootstrapped yearly cost of illness was €2,222,763,789 (€1,372,412,403–€3,260,248,300), only 22% was healthcare-related. Costs per patient were €16,852.


Although healthcare costs of non-institutionalized Borderline patients might not be disproportionate, total societal costs are substantial.

Original article
Copyright © Elsevier Masson SAS 2007

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