The implications of DSM-III personality disorders for patients with major depression

We studied 78 inpatients with DSM-III major depression. Forty-one (53%) had a concurrent personality disorder (PD) according to a detailed structured interview for DSM-III personality disorders. The patients with depression plus PD differed from patients with depression alone on numerous measures. T...

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Bibliographic Details
Published in:Journal of affective disorders 1984-01, Vol.7 (3), p.309-318
Main Authors: Pfohl, Bruce, Stangl, Dalene, Zimmerman, Mark
Format: Article
Language:English
Subjects:
Adult
Adult and adolescent clinical studies
Antidepressant medication
Antidepressive Agents - therapeutic use
Biological and medical sciences
Depression
Depressive Disorder - diagnosis
Depressive Disorder - genetics
Depressive Disorder - therapy
Dexamethasone
Dexamethasone suppression test
DSM-III major depression
Electroconvulsive Therapy
Female
Humans
Hydrocortisone - blood
Male
Manuals as Topic
Medical sciences
Mood disorders
Personality disorders
Personality Disorders - diagnosis
Personality Disorders - genetics
Personality Disorders - therapy
Prognosis
Psychological Tests
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk
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Summary:We studied 78 inpatients with DSM-III major depression. Forty-one (53%) had a concurrent personality disorder (PD) according to a detailed structured interview for DSM-III personality disorders. The patients with depression plus PD differed from patients with depression alone on numerous measures. The PD patients had earlier onset; higher HRS scores; poorer social support; more life stressors; more frequent separation and divorce; more frequent nonserious suicide attempts, less frequent dexamethasone nonsuppression; poorer response to antidepressant medication; and higher risk for depression, alcoholism and antisocial personality among first-degree relatives. The PD subgroup shares many attributes with Winokur's subtype of depression spectrum disorder and Akiskal's character spectrum disorder. An attempt to identify a subgroup of personality disorders which might be an atypical affective disorder was inconclusive. However, patients in DSM-III cluster III were similar to the patients with no-PD on the dexamethasone suppression test, response to treatment, and familial risk for depression and antisocial personality.
ISSN:0165-0327
1573-2517
DOI:10.1016/0165-0327(84)90052-1