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The Edinburgh Primary Care Depression Study: Personality Disorder and Outcome

Published online by Cambridge University Press:  02 January 2018

Douglas A. Patience ,
Ralph J. McGuire ,
Allan I. F. Scott  and
Christopher P. L. Freeman
Douglas A. Patience*
Affiliation:
Royal Edinburgh Hospital, Edinburgh EH 10 5HF
Ralph J. McGuire
Affiliation:
Royal Edinburgh Hospital, Edinburgh EH 10 5HF
Allan I. F. Scott
Affiliation:
Royal Edinburgh Hospital, Edinburgh EH 10 5HF
Christopher P. L. Freeman
Affiliation:
Royal Edinburgh Hospital, Edinburgh EH 10 5HF
*
Dr Patience, Clinical Research Fellow, Royal Edinburgh Hospital, Morningside Terrace, Edinburgh EH10 5HF
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Abstract

Background

Little is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care in the UK.

Method

Patients meeting criteria for DSM–III major depressive disorder were randomly allocated to one of four treatments each lasting 16 weeks, then followed up for 18 months. Assessments were made of depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks.

Results

The prevalence of personality disorder (PD) in the sample of 113 patients was 26%. Patients with a PD were significantly younger and rated more depressed at entry than patients with no personality disorder (NoPD). On completion of treatment patients with a PD were significantly more depressed and had poorer social functioning than the NoPD group. After 18 months there were no differences in ratings of depression or social functioning between the groups.

Conclusions

There was substantial improvement in both the PD and NoPD groups. The presence of personality pathology delays recovery from major depressive illness.

Type
Papers
Information
The British Journal of Psychiatry , Volume 167 , Issue 3 , September 1995 , pp. 324 - 330
Copyright
Copyright © 1995 The Royal College of Psychiatrists

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References

Akiskal, H. S., Bitar, A. H., Puzantian, V. R., et al (1978) The nosological status of neurotic depression. Archives of General Psychiatry, 35, 756–765.10.1001/archpsyc.1978.01770300098011Google Scholar
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM–III). Washington, DC: APA.Google Scholar
Black, D. W., Bell, S., Hulbert, J., et al (1988) The importance of Axis II in patients with major depression. Journal of Affective Disorders, 14, 115–122.10.1016/0165-0327(88)90053-5Google Scholar
Casey, P. & Tyrer, P. (1990) Personality disorder and psychiatric illness in general practice. British Journal of Psychiatry, 156, 261–265.10.1192/bjp.156.2.261Google Scholar
Charney, N., Nelson, J. C. & Quinlan, D. M. (1981) Personality traits and disorder in depression. American Journal of Psychiatry, 138, 1601–1604.Google Scholar
Freeman, A., Pretzer, J., Flemming, B., et al (1990) Clinical Application of Cognitive Therapy. New York: Plenum.10.1007/978-1-4684-0007-6Google Scholar
Lewis, A. J. (1934) Melancholia: A clinical survey of depressive states. Journal of Mental Science, 80, 277–378.10.1192/bjp.80.329.277Google Scholar
Mann, A. H., Jenkins, R. & Belsey, E. (1981) The twelve month outcome of patients with a neurotic illness in general practice. Psychological Medicine, 11, 535–550.10.1017/S0033291700052855Google Scholar
Paykel, E. S. & Priest, R. G. (1992) Recognition and management of depression in general practice. British Medical Journal, 305, 1198–1202.10.1136/bmj.305.6863.1198Google Scholar
Pfohl, B., Stangl, D. & Zimmerman, M. (1984) The implications of DSM–III personality disorders for patients with major depression. Journal of Affective Disorders, 7, 309–318.10.1016/0165-0327(84)90052-1Google Scholar
Pilkonis, P. & Frank, E. (1988) Personality pathology in recurrent depression: nature, prevalence, and relationship to treatment response. American Journal of Psychiatry, 145, 435–441.Google Scholar
Reich, J. H. & Vasile, R. G. (1993) Effects of personality disorders on the treatment outcome of Axis I conditions: an update. Journal of Nervous and Mental Disease, 181, 475–484.10.1097/00005053-199308000-00002Google Scholar
Remington, M. & Tyrer, P. (1979) The social functioning schedule – a brief semi-structured interview. Social Psychiatry, 14, 151–157.10.1007/BF00582182Google Scholar
Scott, A. I. F. & Freeman, C. P. L. (1992) Edinburgh Primary Care Depression Study: Treatment outcome, patient satisfaction, and cost after 16 weeks. British Medical Journal, 304, 883–887.10.1136/bmj.304.6831.883Google Scholar
Shea, M. T., Pilkonis, P. A., Beckham, E., et al (1990) Personality disorders and treatment outcome in the NIMH Treatment of Depression Collaborative Research Program. American Journal of Psychiatry, 147, 711–718.Google Scholar
Thompson, L. W., Gallagher, D. & Czirr, R. (1988) Personality disorder and outcome in the treatment of late-life depression. Journal of Geriatric Psychiatry, 21, 133–153.Google Scholar
Tyrer, P., Alexander, M. S., Cicchetti, D., et al (1979) Reliability of a schedule for rating personality disorders. British Journal of Psychiatry, 135, 168–174.10.1192/bjp.135.2.168Google Scholar
Tyrer, P., Casey, P. & Gall, J. (1983) Relationship between neurosis and personality disorder. British Journal of Psychiatry, 142, 404–408.10.1192/bjp.142.4.404Google Scholar
Weissman, M. M., Klerman, G. L., Paykel, E. S., et al (1974) Treatment effects on the social adjustment of depressed patients. Archives of General Psychiatry, 30, 771–778.10.1001/archpsyc.1974.01760120033006Google Scholar
Williams, P., Tarnopolsky, A. & Hand, D. (1980) Case definition and case identification in psychiatric epidemiology: review and assessment. Psychological Medicine, 10, 101–114.10.1017/S0033291700039635Google Scholar
Zimmerman, M., Coryell, W., Pfohl, B., et al (1986) ECT response in depressed patients with and without a DSM–III personality disorder. American Journal of Psychiatry, 143, 1030–1032.Google Scholar
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