Giles Newton-Howes1, Peter Tyrer, Tony Johnson. 1. Department of Psychological Medicine, Division of Neuroscience and Mental Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK.
Abstract
BACKGROUND: There is conflicting evidence about the influence of personality disorder on outcome in depressive disorders. AIMS: Meta-analysis of studies in which a categorical assessment of personality disorder or no personality disorder was made in people with depressive disorders, and categorical outcome (recovered/not recovered) also determined. METHOD: Systematic electronic search of the literature for relevant publications. Hand searches of Journal of Affective Disorders and recent reviews, with subsequent meta-analysis of selected studies. RESULTS: Comorbid personality disorder with depression was associated with a doubling of the risk of a poor outcome for depression compared with no personality disorder (random effects model OR=2.18, 95% CI 1.70-2.80), a robust finding maintained with only Hamilton-type depression criteria at outcome (OR=2.20, 95% CI 1.61-3.01). All treatments apart from electroconvulsive therapy (ECT) showed this poor outcome, and the ECT group was small. CONCLUSIONS: Combined depression and personality disorder is associated with a poorer outcome than depression alone.
BACKGROUND: There is conflicting evidence about the influence of personality disorder on outcome in depressive disorders. AIMS: Meta-analysis of studies in which a categorical assessment of personality disorder or no personality disorder was made in people with depressive disorders, and categorical outcome (recovered/not recovered) also determined. METHOD: Systematic electronic search of the literature for relevant publications. Hand searches of Journal of Affective Disorders and recent reviews, with subsequent meta-analysis of selected studies. RESULTS: Comorbid personality disorder with depression was associated with a doubling of the risk of a poor outcome for depression compared with no personality disorder (random effects model OR=2.18, 95% CI 1.70-2.80), a robust finding maintained with only Hamilton-type depression criteria at outcome (OR=2.20, 95% CI 1.61-3.01). All treatments apart from electroconvulsive therapy (ECT) showed this poor outcome, and the ECT group was small. CONCLUSIONS: Combined depression and personality disorder is associated with a poorer outcome than depression alone.
Authors: Leslie C Morey; M Tracie Shea; John C Markowitz; Robert L Stout; Christopher J Hopwood; John G Gunderson; Carlos M Grilo; Thomas H McGlashan; Shirley Yen; Charles A Sanislow; Andrew E Skodol Journal: Am J Psychiatry Date: 2010-02-16 Impact factor: 18.112
Authors: Boadie W Dunlop; Jared A DeFife; Lauren Marx; Steven J Garlow; Charles B Nemeroff; Scott O Lilienfeld Journal: Int Clin Psychopharmacol Date: 2011-11 Impact factor: 1.659