Mental Health Services Utilization in Patients with Major Depressive Disorder and Personality Disorders: A Retrospective Analysis in a Mexican Tertiary-Level Psychiatric Hospital

Abstract Major Depressive Disorder (MDD) and Personality Disorders (PD) frequently coexist, amplifying clinical complexity and healthcare resource utilization. This retrospective study investigates the relationship between PD comorbidity and mental health service utilization among 237 inpatients diagnosed with MDD at a Mexican tertiary psychiatric hospital. Data were collected from clinical records using DSM-IV criteria and analyzed through descriptive and multivariate methods. Results indicate that individuals with both MDD and PD require more intensive care than those with MDD alone. Patients with PD were hospitalized earlier, had longer treatment durations, and needed more complex pharmacological regimens. Those with subthreshold PD traits exhibited intermediate patterns of service utilization. Notably, PD was associated with higher hospitalization rates and increased prescription medication use. Sociodemographic factors, including sex, education, and employment status, significantly influenced these patterns, with women and individuals with higher education levels more likely to exhibit PD traits. The findings underscore the need for integrated care models tailored to this high-risk population. PD comorbidity exacerbates symptom severity and functional impairments, demanding coordinated approaches that address both conditions simultaneously. Early intervention strategies could mitigate long-term healthcare burdens, particularly for younger patients. This study highlights the critical impact of PD on the clinical and resource needs of MDD patients. By providing actionable insights into service utilization patterns, it advocates for the development of personalized, multidisciplinary interventions to enhance care quality and efficiency for this vulnerable group.