title: Does personality disorder co-morbidity impact treatment outcome for patients with major depression? A multi-level analysis.
abstract: In literature, there exists disagreement regarding the impact of comorbid personality disorder(s) (PD[s]) on treatment outcome for patients with major depressive disorder (MDD). The aim of this paper was to investigate whether statistical heterogeneity and inter-dependency are potential moderators of the effect of co-morbid PDs on outcome for patients with MDD. Clinician-rated MADRS scores and DSM-IV Axis II personality disorder diagnoses were obtained from 562 outpatients with MDD who received 6 months of combined psycho- and pharmacotherapy. Single-level regression showed significantly worse treatment outcome among patients with co-morbid PD, as compared to patients with no PD. After controlling for statistical heterogeneity and interdependency, treatment outcome was no longer significantly worse for patients with co-morbid PD. In conclusion, heteroscedasticity and inter-dependency should be considered as potentially compelling explanations for inconsistencies in findings on treatment outcome for depressed patients with co-morbid PDs.
authors.affiliation: Ghent University, Department of Developmental, Personality and Social Psychology, H. Dunantlaan 2, B-9000 Ghent, Belgium. Marleen.DeBolle@UGent.be
authors.forename: Marleen
authors.initials: M
authors.lastname: De Bolle
authors.forename: Filip
authors.initials: F
authors.lastname: De Fruyt
authors.forename: Lena C
authors.initials: LC
authors.lastname: Quilty
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Rolland
authors.forename: Mieke
authors.initials: M
authors.lastname: Decuyper
authors.forename: R Michael
authors.initials: RM
authors.lastname: Bagby
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000150:complications* / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010554:Personality Disorders / Q000150:complications* / Q000628:therapy; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012720:Severity of Illness Index; D013841:Thiazepines / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D013841:Thiazepines; D005473:Fluoxetine; C050504:tianeptine