Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture chosen topic – time and place
See Trial Lecture.
Trial Lecture given topic – time and place
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Adjudication committee
- First opponent: Associate professor Lene Halling Hastrup, University of Southern Denmark,
- Second opponent: Professor Jens Thimm, The Arctic University of Norway (UiT),
- Third member and chair of the evaluation committee: Professor Kristin Romvig Øvergaard, University of Oslo
Chair of the Defence
Professor II Nils Eiel Steen, University of Oslo
Principal Supervisor
Professor II Elfrida Hartveit Kvarstein, University of Oslo
Summary
This thesis, within clinical psychology and health economics, examines the societal costs of personality disorders (PDs) in Norway. The aims were to estimate the societal costs associated with the full range of DSM-5 PDs, provide the first explicit estimate for avoidant PD, and investigate whether specific PD categories or dimensional measures of personality pathology severity were associated with variations in societal costs.
It is based on cross-sectional data (2017–2020) from the Norwegian Network for Personality Disorders, a multicenter treatment and research collaboration within specialist mental health services. Resource use, including healthcare utilization and productivity losses before assessment, was estimated using a societal cost-of-illness approach. Regression analyses examined the independent contributions of PD diagnoses and dimensional measures of personality pathology while controlling for common comorbid mental disorders.
PDs were associated with substantial societal costs, comparable to those reported for schizophrenia and higher than those for anxiety and depressive disorders. Productivity losses accounted for about two-thirds of total costs, largely reflecting that up to 80% of patients were outside the workforce. Costs associated with avoidant PD were similar to those observed across DSM-5 PDs. Neither specific PD categories nor dimensional measures of severity were independently associated with overall societal costs, suggesting that the economic burden is largely related to impaired functioning shared across treatment-seeking patients rather than to diagnostic subtype or differences in severity.
Beyond economic consequences, PDs are associated with profound psychological distress, impaired functioning, and reduced quality of life. The findings highlight the need for effective treatment across the full spectrum of PDs and interventions that improve occupational functioning, thereby alleviating patients' suffering while reducing societal costs.
Additional information
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