Comorbid personality disorder and treatment use in a community sample of youths: a 20-year follow-up

Objective: The impact of comorbid personality disorder (PD) on subsequent treatment and psychotropic drug use was examined in a representative sample of over 700 individuals. Method: Axis I disorders and PD were assessed by self- and mother-report at mean ages 13 and 22 years, and by self-report at mean age 33. Mothers reported treatment use by participants before mean age 33; participants reported treatment and psychotropic drug use at mean age 33. Results: Individuals with multiple axis I disorders without PD, axis I disorder-PD comorbidity, and single disorders were compared simultaneously to individuals not diagnosed. Overall, odds of subsequent and past year treatment or psychotropic drug use or both were highest when PD co-occurred with a mood, an anxiety, a disruptive, or a substance use disorder. Conclusion: Co-occurring personality pathology may contribute to elevated mental health service use, including use of psychotropic drugs, among young adults in the community.