Personality disorders in pediatric and adolescent populations: Hospital discharge rates in Chile, 2021-2024
DOI:
https://doi.org/10.52611/confluencia.2026.1903Keywords:
Adolescent, Chile, Epidemiology, Hospitalization, Personality disordersAbstract
Introduction: Personality disorders may manifest during adolescence and be associated with functional impairment and crises requiring hospitalization. In Chile, information on their epidemiological patterns among children and adolescents is limited. Objective: To describe hospital discharge rate for personality disorders among individuals aged 5 to 19 years in Chile between 2021 and 2024. Methodology: An observational, descriptive, retrospective study based on records from the Department of Health Statistics and Information. Hospital discharge rates were calculated by year, sex, and age group, along with mean length of hospital stay and distribution of discharge diagnoses. Result: A total of 5.821 hospital discharges were recorded, with an overall hospital discharge rate of 40,16 per 100.000 inhabitants, increasing from 30,00 in 2021 to 45,76 in 2024. Females had a higher hospital discharge rate than males (67,63 versus 13,88 per 100.000 inhabitants), and the 15-19-year age group had the highest rate (87,38 per 100.000 inhabitants). The mean length of hospital stay was 15,23 days. Emotionally unstable personality disorder (46,37%) and unspecified personality disorder (41,49%) accounted for 87,86% of all discharges. Conclusion: Hospital discharge rates increased during the study period, with a greater burden of hospitalization among females and adolescents aged 15-19 years. These findings provide national epidemiological information and may help guide detection strategies and the planning of child and adolescent mental health services. The descriptive design does not allow the causes of the observed differences to be established.
References
1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. [Internet]. 5th ed., text rev. Washington (DC): APA Publishing; 2022 [citado el 3 de marzo 2026]. Disponible en: https://www.psychiatry.org/psychiatrists/practice/dsm
2. World Health Organization. ICD-11: International Classification of Diseases 11th Revision [Internet]. Geneva: WHO; 2022 [citado el 3 de marzo 2026]. Disponible en: https://icd.who.int/
3. Shadid J, Ferrari AJ, Bach B, Sellbom M, Sharp C, Hutsebaut J, et al. The global epidemiology of personality disorder: a systematic review and meta-regression. Lancet Psychiatry [Internet]. 2025 [citado el 3 de marzo 2026];12(12):932-46. Disponible en: https://doi.org/10.1016/s2215-0366(25)00299-8
4. Winsper C, Bilgin A, Thompson A, Marwaha S, Chanen AM, Singh SP, et al. The prevalence of personality disorders in the community: a global systematic review and meta-analysis. Br J Psychiatry [Internet]. 2020 [citado el 3 de marzo 2026];216(2):69-78. Disponible en: https://doi.org/10.1192/bjp.2019.166
5. Macaya X, Moraga-Escobar E, Lagos Muñoz P, Rojas Ponce R, Schmidt K, Guzmán-Castillo A, et al. Prevalencia de vida y último año de trastornos psiquiátricos en nivel primario de atención en una región del sur de Chile. Gac Med Espirit [Internet]. 2024 [citado el 23 de septiembre 2026];26:2584. Disponible en: https://revgmespirituana.sld.cu/index.php/gme/article/view/2584/pdf
6. Blasco L, Ferrer T, Campusano-Castañeda I. Annual Profile of Patients at a Child and Adolescent Mental Health Day Hospital in Chile. Eur Psychiatry [Internet]. 2026 [citado el 23 de septiembre 2026];69(Supl 1):S512-3. Disponible en: https://doi.org/10.1192/j.eurpsy.2026.11171
7. Chanen AM, Thompson KN. The Age of Onset of Personality Disorders. In: de Girolamo G, McGorry PD, Sartorius N, eds. Age of onset of mental disorders: etiopathogenetic and treatment implications [Internet]. Cham: Springer International Publishing; 2019 [citado el 7 de marzo 2026]. p. 183-201. Disponible en: https://doi.org/10.1007/978-3-319-72619-9_10
8. Guilé JM, Boissel L, Alaux-Cantin S, de La Rivière SG. Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies. Adolesc Health Med Ther [Internet]. 2018 [citado el 23 de septiembre 2026];9:199-210. Disponible en: https://doi.org/10.2147/AHMT.S156565
9. Sharp C, Wall K. DSM-5 Level of Personality Functioning: Refocusing Personality Disorder on What It Means to Be Human. Annu Rev Clin Psychol [Internet]. 2021 [citado el 23 de septiembre 2026];17:313-37. Disponible en: https://doi.org/10.1146/annurev-clinpsy-081219-105402
10. Sekowski M, Gambin M, Sumlin E, Sharp C. Associations between symptoms of borderline personality disorder and suicidality in inpatient adolescents: The significance of identity disturbance. Psychiatry Res [Internet]. 2022 [citado el 23 de septiembre 2026];312:114558. Disponible en: https://doi.org/10.1016/j.psychres.2022.114558
11. Sharp C. Personality disorders. N Engl J Med [Internet]. 2022 [citado el 12 de marzo 2026];387(10):916-23. Disponible en: https://doi.org/10.1056/NEJMra2120164
12. Simonsen S, Bateman A, Bohus M, Dalewijk HJ, Doering S, Kaera A, et al. European guidelines for personality disorders: past, present and future. Borderline Personal Disord Emot Dysregul [Internet]. 2019 [citado el 14 de marzo 2026];6:9. Disponible en: https://doi.org/10.1186/s40479-019-0106-3
13. Keepers GA, Fochtmann LJ, Anzia JM, Benjamin S, Lyness JM, Mojtabai R, et al. The American Psychiatric Association Practice Guideline for the Treatment of Patients With Borderline Personality Disorder. Am J Psychiatry [Internet]. 2024 [citado el 14 de marzo 2026];181(11):1024-8. Disponible en: https://doi.org/10.1176/appi.ajp.24181010
14. Dossa A, Hein M, Bikrani O, Wacquier B, Point C. Impact of Comorbid Personality Disorder on the Risk of Involuntary Hospitalization in Patients Referred for Urgent Forensic Assessment: A Cross-Sectional Study. Brain Sci [Internet]. 2024 [citado el 17 de marzo 2026];14(10):961. Disponible en: https://doi.org/10.3390/brainsci14100961
15. Gkitakou A, Have MT, Batelaan NM, Luik AI, Penninx BWJH. Anxiety and mood disorders on the rise: exploring clinical profiles and risk factors. Br J Psychiatry [Internet]. 2025 [citado el 17 de marzo 2026]:228(6):513-20. Disponible en: https://doi.org/10.1192/bjp.2025.10454
16. Levkovich I, Yatzkar U, Shenaar-Golan V. Age and Gender Differences in Emotional and Behavioral Functioning Among Youth Referred to a Psychiatric Outpatient Clinic at a Public Hospital. Children (Basel) [Internet]. 2025 [citado el 20 de marzo 2026];12(6):683. Disponible en: https://doi.org/10.3390/children12060683
17. Wang P, Li C, Bella-Fernández M, Martin-Moratinos M, Castaño LM, del Sol-Calderón P, et al. Comparing Differences between Two Groups of Adolescents Hospitalized for Self-Harming Behaviors with and without Personality Disorders. J Clin Med [Internet]. 2022 [citado el 20 de marzo 2026];11(24):7263. Disponible en: https://doi.org/10.3390/jcm11247263
18. Nazir D, Raj R, Margoob M, Wani ZA. Borderline personality disorder in adolescents: An underrecognized diagnosis. Ind Psychiatry J [Internet]. 2025 [citado el 23 de marzo 2026];34(3):492-7. Disponible en: https://doi.org/10.4103/ipj.ipj_39_25
19. Hamlat EJ, Young JF, Hankin BL. Developmental Course of Personality Disorder Traits in Childhood and Adolescence. J Pers Disord [Internet]. 2020 [citado el 23 de marzo 2026];34(Supl B):25-43. Disponible en: https://doi.org/10.1521/pedi_2019_33_433
20. Kaess M, Cavelti M. Research Review: What we have learned about early detection and intervention of borderline personality disorder. J Child Psychol Psychiatry [Internet]. 2025 [citado el 26 de marzo 2026];66(12):1829-48. Disponible en: https://doi.org/10.1111/jcpp.70011
21. Shen YM, Chan BSM, Liu JB, Zhou YY, Cui XL, He YQ, et al. The prevalence of psychiatric disorders among students aged 6-16 years old in central Hunan, China. BMC Psychiatry [Internet]. 2018 [citado el 26 de marzo 2026];18(1):243. Disponible en: https://doi.org/10.1186/s12888-018-1823-7
22. Mohan L, Yilanli M, Deniz I, Ray S. Conduct Disorder [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 [citado el 29 de marzo 2026]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK470238/
23. Osorio JP, Parrini J, Galdames F, Dinamarca F. Duración de días de hospitalización psiquiátrica en pacientes con diagnósticos GES con y sin comorbilidades. Rev Chil Neuropsiquiatr [Internet]. 2016 [citado el 29 de marzo 2026];54(1):19-26. Disponible en: https://doi.org/10.4067/S0717-92272016000100003
24. Dinsenbacher LL, Imfeld L, Helfenstein F, Moeller J, Lang UE, Huber CG. Specialized short term crisis intervention for patients with personality disorder: Effects on coercion and length of stay. Int J Soc Psychiatry [Internet]. 2024 [citado el 2 de abril 2026];70(8):1516-24. Disponible en: https://doi.org/10.1177/00207640241277161
25. Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P, et al. Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry [Internet]. 2024 [citado el 2 de abril 2026];23(1):4-25. Disponible en: https://doi.org/10.1002/wps.21156
26. Bailo L, Vimercati P, Caslini M, Damiano S, Pellegrini E. Personality disorder not otherwise specified heterogeneity and its implication in psychiatric residential treatment. Eur Psychiatry [Internet]. 2021 [citado el 5 de abril 2026];64(Supl 1):S234. Disponible en: https://doi.org/10.1192/j.eurpsy.2021.626
27. Curry A, Riddle M. Personality Disorders in the Emergency Department. In: Zun LS, Nordstrom K, Wilson MP, eds. Behavioral Emergencies for Healthcare Providers [Internet]. Cham: Springer; 2021 [citado el 5 de abril 2026]. p. 141-50. Disponible en: https://doi.org/10.1007/978-3-030-52520-0_13
28. Massaal-van der Ree LY, Eikelenboom M, Hoogendoorn AW, Thomaes K, van Marle HJF. Cluster B versus Cluster C Personality Disorders: A Comparison of Comorbidity, Suicidality, Traumatization and Global Functioning. Behav Sci (Basel) [Internet]. 2022 [citado el 8 de abril 2026];12(4):105. Disponible en: https://doi.org/10.3390/bs12040105
29. Rizvi A, Torrico TJ. Obsessive-Compulsive Personality Disorder [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 [citado el 8 de abril 2026]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK597372/
30. Hansen BJ, Thomas J, Torrico TJ. Dependent Personality Disorder [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 [citado el 11 de abril 2026]. Disponible en: https://www.ncbi.nlm.nih.gov/books/NBK606086/
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Revista Confluencia

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.



