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

J Affect Disord. 1984 Dec;7(3-4):309-18. doi: 10.1016/0165-0327(84)90052-1.

Abstract

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.

MeSH terms

  • Adult
  • Antidepressive Agents / therapeutic use
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / genetics
  • Depressive Disorder / therapy
  • Dexamethasone
  • Electroconvulsive Therapy
  • Female
  • Humans
  • Hydrocortisone / blood
  • Male
  • Manuals as Topic
  • Personality Disorders / diagnosis*
  • Personality Disorders / genetics
  • Personality Disorders / therapy
  • Prognosis
  • Psychological Tests
  • Risk

Substances

  • Antidepressive Agents
  • Dexamethasone
  • Hydrocortisone