Personality disorder and the outcome of depression: meta-analysis of published studies.
BACKGROUND
There is conflicting evidence about the influence of personality disorder on outcome in depressive disorders.


OBJECTIVE
Meta-analysis of studies in which a categorical assessment of personality disorder or no personality disorder was made in people with depressive disorders, and categorical outcome (recovered/not recovered) also determined.


METHODS
Systematic electronic search of the literature for relevant publications. Hand searches of Journal of Affective Disorders and recent reviews, with subsequent meta-analysis of selected studies.


RESULTS
Comorbid personality disorder with depression was associated with a doubling of the risk of a poor outcome for depression compared with no personality disorder (random effects model OR=2.18, 95% CI 1.70-2.80), a robust finding maintained with only Hamilton-type depression criteria at outcome (OR=2.20, 95% CI 1.61-3.01). All treatments apart from electroconvulsive therapy (ECT) showed this poor outcome, and the ECT group was small.


CONCLUSIONS
Combined depression and personality disorder is associated with a poorer outcome than depression alone.
Newton-Howes
Giles
G
Department of Psychological Medicine, Division of Neuroscience and Mental Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK.
Tyrer
Peter
P
Johnson
Tony
T
D000928:Antidepressive Agents / Q000627:therapeutic use; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy; D004565:Electroconvulsive Therapy; D006801:Humans; D010554:Personality Disorders / Q000523:psychology* / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
D000928:Antidepressive Agents