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Borderline Personality Symptomatology, Experience of Multiple Types of Trauma, and Health Care Utilization Among Women in a Primary Care Setting

J Clin Psychiatry 1998;59(3):108-111

Background: This project was designed to explore the relationship between recollected trauma history, borderline personality symptomatology, and health care utilization among women in a primary care setting.

Method: Women (N=116) consecutively recruited during routine gynecological appointments were given a set of questionnaires that explored 5 types of trauma (i.e., sexual, physical, and emotional abuse; physical neglect; witnessing violence) as well as borderline personality symptomatology. The preceding 12 months of participants' medical records were blindly reviewed to determine several measures of health care utilization (i.e., number of telephone contacts to the facility, physician visits, ongoing and acute prescriptions, specialist referral).

Results: Multiple forms of trauma were related to increased telephone contacts, physician visits, acute prescriptions, and ongoing prescriptions. Borderline personality symptomatology was related to physician visits and ongoing prescriptions. to physician visits and ongoing prescriptions. Neither was related to the number of specialist referrals. Total number of types of trauma and borderline personality symptomatology scores were moderately related to each other (r=.36, p<.01).

Conclusion: With the exception of specialist referrals, the experience of multiple types of trauma and borderline personality symptomatology contribute to higher health care utilization among women in a primary care setting, but not to a substantial degree. The experience of trauma and borderline personality symptomatology appear partially related to each other. This relationship has several implications.