title: Longitudinal comparison of depressive personality disorder and dysthymic disorder.
abstract: BACKGROUND
  Few studies have compared the related diagnostic constructs of depressive personality disorder (DPD) and dysthymic disorder (DD). The authors attempted to replicate findings of Klein and Shih in longitudinally followed patients with personality disorder or major depressive disorder (MDD) in the Collaborative Longitudinal Personality Disorders Study.
  
  
  METHODS
  Subjects (N = 665) were evaluated at baseline and over 2 years (n = 546) by reliably trained clinical interviewers using semistructured interviews and self-report personality questionnaires.
  
  
  RESULTS
  Only 44 subjects (24.6% of 179 DPD and 49.4% of 89 early-onset dysthymic subjects) met criteria for both disorders at baseline. Depressive personality disorder was associated with increased comorbidity of some axis I anxiety disorders and other axis II diagnoses, particularly avoidant (71.5%) and borderline (55.9%) personality disorders. Depressive personality disorder was associated with low positive and high negative affectivity on dimensional measures of temperament. Depressive personality disorder subjects had lower likelihood of remission of baseline MDD at 2-year follow-up, whereas DD subjects did not. The DPD diagnosis appeared unstable over 2 years of follow-up, as only 31% (n = 47) of 154 subjects who had DPD at baseline and also had follow-up assessment met criteria on blind retesting.
  
  
  CONCLUSIONS
  Results from this sample may not generalize to other populations.
  
  
  CONCLUSIONS
  Depressive personality disorder and dysthymic disorder appear to be related but differ in diagnostic constructs. Its moderating effect on MDD and predicted relationship to measures of temperament support the validity of DPD, but its diagnostic instability raises questions about its course, utility, and measurement.
authors.affiliation: New York State Psychiatric Institute and Columbia University, New York, NY 10032, USA. jcmarko@med.cornell.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Markowitz
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Skodol
authors.forename: Eva
authors.initials: E
authors.lastname: Petkova
authors.forename: Hui
authors.initials: H
authors.lastname: Xie
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Cheng
authors.forename: David J
authors.initials: DJ
authors.lastname: Hellerstein
authors.forename: John G
authors.initials: JG
authors.lastname: Gunderson
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sanislow
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Grilo
authors.forename: Thomas H
authors.initials: TH
authors.lastname: McGlashan
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology*; D019263:Dysthymic Disorder / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010554:Personality Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D010555:Personality Inventory; D012720:Severity of Illness Index