The economic burden of Borderline Personality Disorder: direct and indirect costs, and evidence from evaluations of interventions
- 1School of Health and Wellbeing, University of Glasgow , ,
- 2Health Economics and Health Technology Assessment (HEHTA), Institute of Health and Wellbeing (IHW), University of Glasgow , ,
Abstract
Background: Borderline Personality Disorder (BPD) is characterized by longstanding patterns of difficulty in functioning, and when left untreated, BPD can impose a substantial financial burden on individuals and society, in terms of higher healthcare costs as well as broader societal costs.
Aims: To conduct a critical review of the direct and indirect costs related to BPD. Additionally, to critically evaluate the economic evidence on interventions for BPD.
Methods: A comprehensive search strategy was conducted across PsycINFO, PubMed, and SCOPUS. Studies were screened in two phases: an initial title and abstract review, followed by full-text screening against a predefined eligibility criteria.
Results: Across 23 studies, high direct and indirect costs were consistently reported. Economic evaluations primarily examined established psychological interventions for BPD, such as Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and Schema-Focused Therapy (SFT), comparing costs and quality-of-life outcomes, with most demonstrating cost savings through reduced inpatient and emergency service use.
Conclusions: This review highlights the substantial economic burden of BPD, driven by high service use, productivity losses, and unmet needs. While interventions such as DBT, CBT and SFT show potential cost-effectiveness, inconsistent cost definitions and the omission of key components, including informal care and long-term impairment, likely lead to an underestimation of true costs. More comprehensive and standardized economic evaluations are needed.
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BibTeX
@article{ghoyal2026economic,
title = {{The economic burden of Borderline Personality Disorder: direct and indirect costs, and evidence from evaluations of interventions}},
author = {Monica Ghoyal and Greta Dertwinkel and Katie Nicol and Ruchika Gajwani and Manuela Deidda},
journal = {Frontiers in psychiatry},
year = {2026},
month = sep,
doi = {10.3389/fpsyt.2026.1835343},
url = {https://europepmc.org/article/PMC/PMC13662043},
note = {CC BY},
}
RIS
TY - JOUR
TI - The economic burden of Borderline Personality Disorder: direct and indirect costs, and evidence from evaluations of interventions
AU - Monica Ghoyal
AU - Greta Dertwinkel
AU - Katie Nicol
AU - Ruchika Gajwani
AU - Manuela Deidda
PY - 2026
DA - 2026/09/30
JO - Frontiers in psychiatry
DO - 10.3389/fpsyt.2026.1835343
UR - https://europepmc.org/article/PMC/PMC13662043
AB - Background: Borderline Personality Disorder (BPD) is characterized by longstanding patterns of difficulty in functioning, and when left untreated, BPD can impose a substantial financial burden on individuals and society, in terms of higher healthcare costs as well as broader societal costs. Aims: To conduct a critical review of the direct and indirect costs related to BPD. Additionally, to critically evaluate the economic evidence on interventions for BPD. Methods: A comprehensive search strategy was conducted across PsycINFO, PubMed, and SCOPUS. Studies were screened in two phases: an initial title and abstract review, followed by full-text screening against a predefined eligibility criteria. Results: Across 23 studies, high direct and indirect costs were consistently reported. Economic evaluations primarily examined established psychological interventions for BPD, such as Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and Schema-Focused Therapy (SFT), comparing costs and quality-of-life outcomes, with most demonstrating cost savings through reduced inpatient and emergency service use. Conclusions: This review highlights the substantial economic burden of BPD, driven by high service use, productivity losses, and unmet needs. While interventions such as DBT, CBT and SFT show potential cost-effectiveness, inconsistent cost definitions and the omission of key components, including informal care and long-term impairment, likely lead to an underestimation of true costs. More comprehensive and standardized economic evaluations are needed.
SN - 1664-0640
ER -