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Personality disorder and the outcome of depression: Meta-analysis of published studies

  • Giles Newton-Howes (a1), Peter Tyrer (a1) and Tony Johnson (a1)
Abstract
Background

There is conflicting evidence about the influence of personality disorder on outcome in depressive disorders.

Aims

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.

Method

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% C11.70–2.80), a robust finding maintained with only Hamilton-type depression criteria at outcome (OR=2.20, 95% C11.61–3.01). 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.

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Copyright
Corresponding author
Professor Peter Tyrer, Department of Psychological Medicine, Division of Neuroscience and Mental Health, Imperial College London, St Dunstan's Road, London W6 8RP, UK. E-mail: p.tyrer@imperial.ac.uk
Footnotes
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Declaration of interest

P.T. and T.J. belong to a UK Medical Research Council Cooperative Group (Mencog) evaluating mental health interventions. P.T. is Editor of the British Journal of Psychiatry but had no part in the evaluation of this paper.

Footnotes
References
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Personality disorder and the outcome of depression: Meta-analysis of published studies

  • Giles Newton-Howes (a1), Peter Tyrer (a1) and Tony Johnson (a1)
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