Personality Features and Response to Acute Treatment in Recurrent Depression

Frank, Ellen; Kupfer, David J.; Jacob, Miriam; Jarrett, David B.

doi:10.1521/pedi.1987.1.1.14

Cited by 110 publications

(53 citation statements)

References 4 publications

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“…A comparison with the literature data is not easy. Many authors have found that concomitant personality disorders have negative effects on the treatment outcome of patients with major depression, both on depressive symptoms and on social functioning (51)(52)(53)(54). A study by Kool and others compared combined treatment and pharmacotherapy of depression, examining the effect of personality disorders on differences in clinical response (26).…”

Section: Discussionmentioning

confidence: 99%

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

et al. 2006

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Objective: Combined treatment with psychotherapy and antidepressants is more effective than monotherapies. Recent data show that combined therapy has better results in patients with depression and Axis II codiagnosis. The aim of this study was to compare combined treatment using interpersonal psychotherapy (IPT) with pharmacotherapy alone in patients with depression and borderline personality disorder (BPD).Methods: There were 39 consecutive outpatients diagnosed with BPD who presented with a major depressive episode enrolled in this study. They were randomly assigned to 1 of 2 treatment groups: fluoxetine 20 mg to 40 mg daily or fluoxetine 20 mg to 40 mg daily plus IPT 1 session weekly. Owing to noncompliance, 7 patients dropped out. We assessed the 32 patients who completed the 24 weeks of treatment at baseline, Week 12, and Week 24, using a semistructured interview for clinical characteristics, the Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS), and 2 self-report questionnaires, that is, the Satisfaction Profile (SAT-P) for quality of life and the 64-item Inventory for Interpersonal Problems (IIP-64). We performed statistical analysis, using univariate general linear models with 2 factors: duration and type of treatment.Results: Changes in remission rates, CGI, and HARS score did not differ between treatments. According to changes in the HDRS scores; changes in psychological functioning and social functioning scores on the SAT-P; and changes in vindictive or self-centred, cold or distant, intrusive or needy, and socially inhibited scores on the IIP-64, combined therapy was superior to fluoxetine alone. Conclusions:Combined therapy with IPT is more effective than antidepressant therapy alone, both in treating symptoms of major depression and in improving dimensions of quality of life and interpersonal functioning. Clinical implications· Combining fluoxetine and IPT is a more effective treatment of major depression symptoms in patients with BPD than fluoxetine alone. · Combined treatment produces more significant improvements in quality of life and interpersonal functioning in patients with BPD suffering from depression. · Combined therapy with fluoxetine and IPT can be considered a treatment of choice for major depression with BPD. Limitations· The sample size was relatively small; thus, conclusive statements cannot be made. · We did not compare combined therapy and IPT alone. · Follow-up data on recurrences of major depressive episodes have not yet been analyzed.

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Section: Discussionmentioning

confidence: 99%

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

et al. 2006

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“…Premorbid testing shows greater neuroticism in those who later develop depression than in those who do not, and highly elevated neuroticism scores during depression are predictive of poor prognosis (Enns & Cox, 1997). Although the effects of extraversion are less robust than the comparable findings for neuroticism, low extraversion was shown to be associated with poorer prognosis (Frank, Kupfer, Jacob, & Jarrett, 1987;Hirschfeld, Klerman, Clayton, & Keller, 1983). Hence, a combination of neuroticism and introversion was considered in the present study as a predisposing-todepression (PD) personality profile.…”

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confidence: 99%

Predisposition to depression and implicit emotion processing

Knyazev

Bocharov

Savostyanov

et al. 2015

Journal of Clinical and Experimental Neuropsychology

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Depression, one of the most widespread mental disorders, is associated with considerable alterations in emotional functioning. It is unclear whether these alterations are associated with clinical depression or exist already at preclinical stages. Here, in clinically healthy individuals, a combination of neuroticism and introversion was used as a predisposition to depression (PD) scale. Participants were presented with pictures of emotional facial expressions and performed the gender discrimination task, while their electroencephalogram (EEG) was recorded. The affective processing bias (i.e., longer reaction time and higher error rate for angry faces) was found in low, but not in high PD scorers. High PD scorers also showed reduced theta synchronization and enhanced alpha desynchronization in the test interval and higher delta and theta power in the interstimuli interval. The latter effect implies that activity of emotional circuits, which is mirrored in low-frequency oscillations, is tonically increased in predisposed-to-depression individuals, thus precluding an adequate response to external emotional cues. This results in unspecific general activation reflected in enhanced alpha desynchronization and in disrupted ability to differentiate incoming emotional information.

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“…In spite of the availability of preventive pharmaco logical maintenance treatment for recurrent bipolar and unipolar depression, the relatively high rate of recurrences during active drug treatment is still of major concern to clinicians, epidemiologists and biological investigators (Clayton, 1981;Kupfer & Frank, 1987;Frank etal, 1987). The complex relation ship between biochemistry, genetics, environment and personality in the development and phenomeno logy of affective illness has led to the formulation of various vulnerability models of depression (Mendlewicz & Rainer 1974;Brown & Harris, 1986;Turpin & Lader, 1986).…”

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confidence: 99%

Self-esteem in Recovered Bipolar and Unipolar Out-patients

et al. 1993

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The hypothesis of a low self-esteem in depressive patients was tested using the Rosenberg Self-Esteem Scale in 24 recovered unipolar and 27 recovered bipolar patients, compared with a normal control group of 26 subjects matched for age and sex. The hypothesis was confirmed only for unipolars; bipolar patients presented a self-esteem score not significantly different from normal scores. Self-esteem was not related to clinical characteristics of the affective disorder, suggesting that low self-esteem may be a basic component of a depression-prone personality. The investigation of the relationship between self-esteem and social adjustment confirmed the presence of social conformism in bipolar patients and rigidly set low self-esteem in unipolar patients. These results should stimulate the evaluation of different psychotherapeutic treatments in the long-term psychosocial management of affectively ill patients.

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Personality Features and Response to Acute Treatment in Recurrent Depression

Cited by 110 publications

References 4 publications

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

Predisposition to depression and implicit emotion processing

Self-esteem in Recovered Bipolar and Unipolar Out-patients

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