title: Efficacy of pharmacotherapy in depressed patients with and without personality disorders: a systematic review and meta-analysis.
abstract: BACKGROUND
  During the past decades personality pathology was considered to have a negative influence on the outcome of pharmacotherapy of depressive disorders. Recently, there has been a shift towards a less negative opinion. Still, the evidence in the literature remains inconclusive. This may be explained by methodological differences between published studies.
  
  
  OBJECTIVE
  To present a meta-analysis of the results of Randomised Controlled Trials with pharmacotherapy in the treatment of depression with comorbid personality disorders.
  
  
  METHODS
  Systematic literature search for RCTs in adult ambulatory patients with major depressive disorder and comorbid PDs; pooling of data and meta-analysis according to strict methodological criteria.
  
  
  RESULTS
  The difference in remission rates between the groups with and without personality disorders in high quality studies was 3%; this difference was neither statistically significant nor clinically relevant.
  
  
  CONCLUSIONS
  Due to the specific and sensitive methods of the search only six studies could be included in the meta-analysis. Due to lack of data, analyses of drop-out rates could not be made.
  
  
  CONCLUSIONS
  When only data from high quality RCTs are included, comorbidity of personality disorder and major depression does not have a negative effect on the treatment outcome of pharmacotherapy for major depression.
authors.affiliation: Mentrum Mental Health Organization, Amsterdam, The Netherlands. simone.kool@mentrum.nl
authors.forename: Simone
authors.initials: S
authors.lastname: Kool
authors.forename: Robert
authors.initials: R
authors.lastname: Schoevers
authors.forename: Saskia
authors.initials: S
authors.lastname: de Maat
authors.forename: Rien
authors.initials: R
authors.lastname: Van
authors.forename: Pieter
authors.initials: P
authors.lastname: Molenaar
authors.forename: Aukje
authors.initials: A
authors.lastname: Vink
authors.forename: Jack
authors.initials: J
authors.lastname: Dekker
mesh_terms: D015897:Comorbidity; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D010045:Outpatients; D010554:Personality Disorders / Q000150:complications* / Q000523:psychology*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome