BACKGROUND: During the past decades personality pathology was considered to have a negative influence on the outcome of pharmacotherapy of depressive disorders. Recently, there has been a shift towards a less negative opinion. Still, the evidence in the literature remains inconclusive. This may be explained by methodological differences between published studies. OBJECTIVE: To present a meta-analysis of the results of Randomised Controlled Trials with pharmacotherapy in the treatment of depression with comorbid personality disorders. METHOD: Systematic literature search for RCTs in adult ambulatory patients with major depressive disorder and comorbid PDs; pooling of data and meta-analysis according to strict methodological criteria. RESULTS: The difference in remission rates between the groups with and without personality disorders in high quality studies was 3%; this difference was neither statistically significant nor clinically relevant. LIMITATIONS: Due to the specific and sensitive methods of the search only six studies could be included in the meta-analysis. Due to lack of data, analyses of drop-out rates could not be made. CONCLUSION: When only data from high quality RCTs are included, comorbidity of personality disorder and major depression does not have a negative effect on the treatment outcome of pharmacotherapy for major depression.
BACKGROUND: During the past decades personality pathology was considered to have a negative influence on the outcome of pharmacotherapy of depressive disorders. Recently, there has been a shift towards a less negative opinion. Still, the evidence in the literature remains inconclusive. This may be explained by methodological differences between published studies. OBJECTIVE: To present a meta-analysis of the results of Randomised Controlled Trials with pharmacotherapy in the treatment of depression with comorbid personality disorders. METHOD: Systematic literature search for RCTs in adult ambulatory patients with major depressive disorder and comorbid PDs; pooling of data and meta-analysis according to strict methodological criteria. RESULTS: The difference in remission rates between the groups with and without personality disorders in high quality studies was 3%; this difference was neither statistically significant nor clinically relevant. LIMITATIONS: Due to the specific and sensitive methods of the search only six studies could be included in the meta-analysis. Due to lack of data, analyses of drop-out rates could not be made. CONCLUSION: When only data from high quality RCTs are included, comorbidity of personality disorder and major depression does not have a negative effect on the treatment outcome of pharmacotherapy for major depression.
Authors: Carlos M Grilo; Robert L Stout; John C Markowitz; Charles A Sanislow; Emily B Ansell; Andrew E Skodol; Donna S Bender; Anthony Pinto; M Tracie Shea; Shirley Yen; John G Gunderson; Leslie C Morey; Christopher J Hopwood; Thomas H McGlashan Journal: J Clin Psychiatry Date: 2010-06-15 Impact factor: 4.384
Authors: R Michael Bagby; Lena C Quilty; Zindel V Segal; Carolina C McBride; Sidney H Kennedy; Paul T Costa Journal: Can J Psychiatry Date: 2008-06 Impact factor: 4.356
Authors: R C Kessler; H M van Loo; K J Wardenaar; R M Bossarte; L A Brenner; D D Ebert; P de Jonge; A A Nierenberg; A J Rosellini; N A Sampson; R A Schoevers; M A Wilcox; A M Zaslavsky Journal: Epidemiol Psychiatr Sci Date: 2016-01-26 Impact factor: 6.892
Authors: Jay C Fournier; Robert J DeRubeis; Richard C Shelton; Robert Gallop; Jay D Amsterdam; Steven D Hollon Journal: Br J Psychiatry Date: 2008-02 Impact factor: 9.319