The burden of disease of treatment‐seeking patients with a cluster‐C personality disorder in the Netherlands: Quality of life, functioning, and societal costs

Cluster-C personality disorders (PDs) are common in the general population but often overlooked in scientific research and clinical practice. An important step to increase awareness for timely diagnosis and treatment of cluster-C PDs is to investigate the burden of disease in terms of quality of life (QoL), daily functioning and the associated costs to society. In addition, a comparison between these patients and a control group can give insight into (1) the actual societal costs that are associated to cluster-C PD problems and (2) potential societal savings to be made from therapeutic interventions. This study included a total of 375 treatment seeking individuals from 10 mental health sites for outpatient treatment in the Netherlands and 104 individuals without severe mental health issues from the general population. Both QoL (EQ-5D-5L and the MHQoL-7D) and general functioning (WHODAS) were assessed as well as a comprehensive cost-interview to measure relevant costs considering a societal perspective. Results indicate that individuals with a cluster-C PD have severely impaired QoL and functioning compared to the control group. The annual costs associated with cluster-C PD were estimated ranging from €27,355 to €60,454 per patient per year depending on the valuation method used. These costs equate 2.8–4.2 times more than those of control group. Looking at the subgroup in cluster-C PD, no differences in QoL, functioning or societal costs were found between individuals with avoidant, dependent and obsessive-compulsive PD. Overall, the findings advocate for more financial resources to study, prevent and treat cluster-C PDs.