Impact of cluster C personality disorders on outcomes of acute and maintenance treatment in late-life depression.
OBJECTIVE
Personality disorders (PDs) have been associated with poor treatment outcomes in acute treatments for late-life depression and with persistent functional impairment after recovery from an episode of depression.


METHODS
Using survival analysis and mixed-effects models, the authors examined the impact of Cluster C PDs on time-to-response and several aspects of functioning in acute and maintenance treatment of major depression in later life.


RESULTS
Cluster C PDs were associated with longer time-to-response during acute treatment and non-response in continuation or maintenance treatment. Although not statistically significant, there was evidence of a cumulative negative impact of Cluster C PDs and residual depressive symptoms on instrumental activities of daily living (IADLs) during maintenance treatment.


CONCLUSIONS
These findings suggest that screening for PD may be important for clinicians treating late-life depression and that the combination of Cluster C PDs and residual depressive symptoms may predict functional declines even after recovery from the index episode of depression.
Morse
Jennifer Q
JQ
Personality Studies, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213, USA. morsejq@upmc.edu
Pilkonis
Paul A
PA
Houck
Patricia R
PR
Frank
Ellen
E
Reynolds
Charles F
CF
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000208:Acute Disease; D000368:Aged; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D016000:Cluster Analysis; D003131:Combined Modality Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use*; D010043:Outcome and Process Assessment, Health Care; D010552:Personality Assessment / Q000706:statistics & numerical data; D010554:Personality Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D011594:Psychometrics / Q000706:statistics & numerical data; D011613:Psychotherapy; D012008:Recurrence
D000929:Antidepressive Agents, Tricyclic; D009661:Nortriptyline