Economic Evaluation of Psychotherapy for Personality Disorders: burden of disease, cost-effectiveness, and the value of further research and active implementation

Personality disorders are among the most common mental disorders in the general population1,2 and mental healthcare settings3,4 with reported prevalence rates of 13.4 and 45.5 percent, respectively. Personality traits are pervasive and enduring patterns of the ways individuals perceive, relate to, think about, and behave within their environment. When these traits become inflexible and maladaptive they constitute personality disorders. The general diagnostic criteria for personality disorders according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, Text Revision (DSM-IV-TR) of the American Psychiatric Association5 are presented in Table 1.1. Personality disorders can be categorized into three clusters. Cluster A contains the odd or eccentric disorders, including paranoid, schizoid, and schizotypal personality disorder; cluster B covers the dramatic, emotional or erratic disorders, including borderline, antisocial, histrionic, and narcissistic personality disorder; and cluster C consists of the anxious or fearful disorders, including avoidant, dependent, and obsessive-compulsive personality disorder.

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