title: The role of personality pathology in depression treatment outcome with psychotherapy and pharmacotherapy.
abstract: BACKGROUND
  Depressed patients with comorbid personality pathology may fare worse in treatment for depression than those without this additional pathology, and comorbid personality pathology may be associated with superior response in one form of treatment relative to another, though recent findings have been mixed. We aimed to evaluate the effect of personality pathology on time to remission of patients randomly assigned to 1 of 2 treatment strategies for depression and to determine whether personality pathology moderated the effect of treatment assignment on outcome.
  
  
  METHODS
  Individuals undergoing an episode of unipolar major depression (n = 275) received interpersonal psychotherapy (Klerman, Weissman, Rounsaville, & Chevron, 1984) or selective serotonin reuptake inhibitor (SSRI) pharmacotherapy for depression. Depressive symptoms were measured with the HRSD-17. Remission was a mean HRSD-17 score of 7 or below over a period of 3 weeks. Personality disorders were measured according to SCID-II diagnoses, and personality pathology was measured dimensionally by summing the positive probes on the SCID-II.
  
  
  RESULTS
  The presence of at least 1 personality disorder was not a significant predictor of time to remission, but a higher level of dimensionally measured personality pathology and the presence of borderline personality disorder were associated with a longer time to remission. Personality pathology did not moderate the effect of treatment assignment on time to remission.
  
  
  CONCLUSIONS
  The findings suggest that depressed individuals with comorbid personality pathology generally fare worse in treatment for depression, although in this report, the effect of personality pathology did not differ by the type of treatment received.
authors: Department of Psychology, University of Pittsburgh, PA 15213, USA.
authors: Jessica C
authors: JC
authors: Levenson
authors: Meredith L
authors: ML
authors: Wallace
authors: Jay C
authors: JC
authors: Fournier
authors: Paola
authors: P
authors: Rucci
authors: Ellen
authors: E
authors: Frank
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000150:complications* / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D010554:Personality Disorders / Q000150:complications*; D011613:Psychotherapy; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents