Effects of personality disorders on functioning and well-being in major depressive disorder.
BACKGROUND
Patients with depressive disorders have limitations in physical and emotional functioning comparable to patients with chronic medical conditions. Personality disorders (PDs) are also known to be associated with functional impairment.


OBJECTIVE
To determine the effects of PDs on the functioning and well-being of patients with major depressive disorder (MDD).


METHODS
In the Collaborative Longitudinal Personality Disorders Study, 668 patients who met criteria for schizotypal, borderline, avoidant, or obsessive-compulsive PDs or for MDD and no PD were assessed with semi-structured interviews at baseline, 6, 12, 24, and 36 months. In this study, 151 patients who met criteria for current MDD at the 36-month follow-up were compared on the basis of the presence (n = 118) or absence (n = 33) of persistent PD. Physical and social/emotional functioning and well-being were assessed using the Medical Outcomes Study (MOS) Short-Form Health Survey (SF-36). These results were compared with those of a sample of patients with MDD seen in the mental health specialty sector who were followed in the Medical Outcomes Study.


RESULTS
Patients with MDD and co-occurring PD had significantly more impairment on scales measuring role limitations due to emotional problems, social functioning, and general health perceptions than patients with MDD and no PD. Although patients with MDD and no PD were found to have levels of functioning and well-being that were lower in several domains than those previously reported in depressed patients recruited from mental health settings, patients with MDD and co-occurring PD were found to have much lower levels of functioning in all areas than reported samples.


CONCLUSIONS
Co-occurring PDs contribute significantly to impairment in social and emotional functioning and reduced well-being in patients with MDD.
Skodol
Andrew E
AE
Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.
Grilo
Carlos M
CM
Pagano
Maria E
ME
Bender
Donna S
DS
Gunderson
John G
JG
Shea
M Tracie
MT
Yen
Shirley
S
Zanarini
Mary C
MC
McGlashan
Thomas H
TH
D000293:Adolescent; D000328:Adult; D000339:Affect; D001883:Borderline Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009771:Obsessive-Compulsive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D010554:Personality Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011613:Psychotherapy; D012569:Schizotypal Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D012720:Severity of Illness Index; D012919:Social Behavior