Personality Disorders and Outcome of Inpatient Treatment for Depression: A 1-Year Prospective Follow-Up Study

Abstract

This study examines the relationship of personality disorders (PDs) with the outcome of an inpatient treatment for depression. One hundred sixty-eight inpatients with unipolar depression (41% with PD according to SCID-II) were assessed at admission, discharge, and 1-year follow-up. Patients without as well as with PD showed a significant and comparable intake-to-discharge symptom reduction in all inventories. At posttreatment, patients with PD scored higher in self-report measures of symptom severity (Brief Symptom Inventory, Beck Depression Inventory) than patients without PD, due to their higher symptom levels at intake. However, there was no difference in clinician-rated therapy outcome (Hamilton Rating Scale for Depression [17-item version], Global Assessment of Functioning Scale, Clinical Global Impression Scale) between both patient groups at discharge. At 1-year follow-up, patients without PD maintained their treatment outcome, whereas patients with PD showed a slight increase in symptom severity, compared to discharge. The results suggest that a difference in acute treatment outcome between depressed patients with and without PD may be found using self-ratings but not expert ratings of symptom severity. Furthermore, the importance of subsequent outpatient treatment that takes into account the special needs of depressed patients with comorbid PD is highlighted.

Characteristics and differences in treatment outcome of inpatients with chronic vs. episodic major depressive disorders

“…CBASP), the comorbidity rates on both axis I and II were considerably high (Brakemeier et al, 2011). In a comparable inpatient study axis II comorbidities in patients with unipolar depression were also higher (41%), compared with our data (Unger et al, 2013). These differences (low rate of CD and lower rates of axis II comorbidity) in our study are possibly due to the inclusion and exclusion criteria.…”

Patient satisfaction with inpatient psychiatric treatment and its relation to treatment outcome in unipolar depression and schizophrenia

“…Possibly, patients with personality disorder show lower ' openness ' as well as ' extraversion ' and therefore are less satisfi ed with complex treatment situations. In contrast to this, other studies showed no correlation between personality disorder and lower outcome of treatment (Unger et al 2013). …”

The impact of personality disorder pathology on the effectiveness of Cognitive Therapy and Interpersonal Psychotherapy for Major Depressive Disorder

“…depression severity) between individuals with and without PD, multivariable models controlling for significant confounders are rarely used (Casey et al, 2004;Mulder, 2002). Finally, inconsistent findings could also be explained by different outcomes on self-report versus clinician-rated measures of personality pathology and depression outcome (Mulder, 2002;Stanley and Wilson, 2006;Unger et al, 2013).…”