{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T22:17:21Z","timestamp":1740176241242,"version":"3.37.3"},"reference-count":14,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000883","name":"University of Bristol","doi-asserted-by":"publisher","award":["Salary support to JMC"],"award-info":[{"award-number":["Salary support to JMC"]}],"id":[{"id":"10.13039\/501100000883","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012176","name":"Maudsley Charity","doi-asserted-by":"publisher","award":["BRC-2011-10035"],"award-info":[{"award-number":["BRC-2011-10035"]}],"id":[{"id":"10.13039\/100012176","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000380","name":"Guy's and St Thomas' Charity","doi-asserted-by":"publisher","award":["BRC-2011-10035"],"award-info":[{"award-number":["BRC-2011-10035"]}],"id":[{"id":"10.13039\/501100000380","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Summary<\/jats:title>\n\t  <jats:p>Severity of personality disorder is an important determinant of future health. However, this key prognostic variable is not captured in routine clinical practice. Using a large clinical data-set, we explored the predictive validity of items from the Health of Nation Outcome Scales (HoNOS) as potential indicators of personality disorder severity. For 6912 patients with a personality disorder diagnosis, we examined associations between HoNOS items relating to core personality disorder symptoms (self-harm, difficulty in interpersonal relationships, performance of occupational and social roles, and agitation and aggression) and future health service use. Compared with those with no self-harm problem, the total healthcare cost was 2.74 times higher (95% CI 1.66\u20134.52; <jats:italic>P<\/jats:italic> &lt; 0.001) for individuals with severe to very severe self-harm problems. Other HoNOS items did not demonstrate clear patterns of association with service costs. Self-harm may be a robust indicator of the severity of personality disorder, but further replication work is required.<\/jats:p>","DOI":"10.1192\/bjo.2023.509","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:07:21Z","timestamp":1690848441000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":1,"title":["Defining severity of personality disorder using electronic health records: short report"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-6578","authenticated-orcid":false,"given":"Jonathan","family":"Monk-Cunliffe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3182-905X","authenticated-orcid":false,"given":"Giouliana","family":"Kadra-Scalzo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe","family":"Finamore","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2724-4326","authenticated-orcid":false,"given":"Oliver","family":"Dale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mizanur","family":"Khondoker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitesh","family":"Shetty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard D.","family":"Hayes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9257-8699","authenticated-orcid":false,"given":"Paul","family":"Moran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"S2056472423005094_ref13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-035884"},{"key":"S2056472423005094_ref6","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.172.1.11"},{"key":"S2056472423005094_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.05.001"},{"key":"S2056472423005094_ref2","doi-asserted-by":"publisher","DOI":"10.1111\/acps.13004"},{"volume-title":"International Classification of Diseases (11th revision)","year":"2019","key":"S2056472423005094_ref5"},{"key":"S2056472423005094_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-014-0874-4"},{"key":"S2056472423005094_ref9","unstructured":"9 National Health Service. National Schedule of Reference Costs 2017\/18. NHS, 2017 (https:\/\/webarchive.nationalarchives.gov.uk\/ukgwa\/20200501111106\/https:\/\/improvement.nhs.uk\/resources\/reference-costs\/)."},{"key":"S2056472423005094_ref12","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0167103"},{"key":"S2056472423005094_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S2215-0366(16)30029-3"},{"key":"S2056472423005094_ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-244X-9-51"},{"key":"S2056472423005094_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0258(20001215)19:23<3219::AID-SIM623>3.0.CO;2-P"},{"key":"S2056472423005094_ref1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0100979"},{"key":"S2056472423005094_ref11","doi-asserted-by":"publisher","DOI":"10.1521\/pedi_2019_33_459"},{"key":"S2056472423005094_ref14","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.1.62"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472423005094","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:07:28Z","timestamp":1690848448000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472423005094\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,1]]},"references-count":14,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,9]]}},"alternative-id":["S2056472423005094"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2023.509","relation":{},"ISSN":["2056-4724"],"issn-type":[{"type":"electronic","value":"2056-4724"}],"subject":[],"published":{"date-parts":[[2023,8,1]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e137"}}