Personality disorder in the elderly depressed.
The objectives of this study were to examine the association of personality disorder with outcome of depression in older patients (age > or = 60) treated in a psychiatric day hospital for depression and to compare the clinical diagnosis of personality disorder at admission with the results of a semi-structured interview at follow-up. Sixty-four patients were followed up for a mean interval of 30 (13-49) months after admission to the psychiatric day hospital and the semi-structured interview, Social Support Scale, Life Events Inventory, Hamilton Depression Rating Scale and Mini-Mental State Examination administered by a psychiatrist blind to the details of the index admission. Forty-nine informants (a close friend or relative) were also interviewed using the semi-structured interview. Axis II diagnoses at the time of admission were determined from patient records. Personality disorder diagnoses were analysed according to DSM-III-R clusters. Twenty-one (33%) patients fulfilled criteria for personality disorder at admission and 23 (36%) at follow-up. There was strong agreement (k = 0.78) between patient and informant semi-structured interview results and moderate agreement (k = 0.41) between diagnosis at admission and at follow-up. Presence of a personality disorder, and in particular a cluster B personality disorder diagnosis was associated with chronic outcome of depression and with impaired social support. Personality is a significant factor in the outcome of depression in the elderly. It remains unclear whether current methods of assessment tap enduring characteristics, or manifestations of affective state.
Vine
R G
RG
University of Toronto, Baycrest Centre for Geriatric Care, Ontario.
Steingart
A B
AB
D000275:Adjustment Disorders / Q000523:psychology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy*; D015897:Comorbidity; D003631:Day Care, Medical; D003866:Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010552:Personality Assessment; D010554:Personality Disorders / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome