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BackgroundThe impact of personality dysfunction on the outcome of treatment for depression remains debated.AimsTo examine the relationship between the number of prior depressive episodes, personality dysfunction and treatment response for depression.MethodIn a large sample (n = 8229) of adult out-patients with a major depressive episode (DSM–IV), personality dysfunction was assessed using the Standardised Assessment of Personality – Abbreviated Scale (SAPAS). Potential predictors of treatment response at 6 weeks were examined via structural equation modelling.ResultsThe amount of personality dysfunction and number of prior episodes of depression were both associated with poor response to treatment. Once personality dysfunction was controlled for, the number of prior episodes of depression was not associated with treatment response.ConclusionsPersonality dysfunction is associated with impaired short-term response to antidepressant treatment in major depression. The apparent detrimental effect of prior depression on treatment response may be accounted for by pre-existing personality dysfunction.

Clinical ambitions and responsibilities and econom ic possibilities are drifting apart. More than 1{)() clinicians and researchers of 51 clinical institutions from all over Germany came together to provide a sound empirical base to bring these two-conflicting-tendencies into a new balance. The study is focussing on efficiency and effectiveness-rather than on efficacy-of psychodynamic treatment of patients with eating disorders. It is therefore designed as a naturalistic longitudinal study. The prominent statistical tools are: survival-analytic and logistic regression models. Data on patient's state are collected at the begin and the end of treatment; the applied treatment measures are documented weekly. The sample includes 1,200 patients. This size provides a sufficient empirical base to come close to the intended goals. Data analysis clearly demonstrates that there is a lawful relationship between treatment length, treatment amount and outcome .