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02-07 The effect of personality disorder on treatment for depression: psychotherapy vs. medication

Published online by Cambridge University Press:  24 June 2014

RT Mulder ,
PR Joyce ,
SE Luty ,
CM Frampton  and
JD Carter
RT Mulder
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, University of Otago, Christchurch, New Zealand
PR Joyce
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, University of Otago, Christchurch, New Zealand
SE Luty
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, University of Otago, Christchurch, New Zealand
CM Frampton
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, University of Otago, Christchurch, New Zealand
JD Carter
Affiliation:
Department of Psychological Medicine, Christchurch School of Medicine & Health Sciences, University of Otago, Christchurch, New Zealand
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Abstract

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Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006 , pp. 319
Copyright
Copyright © 2006 Blackwell Munksgaard

Aims:

To study the impact of comorbid personality disorders (PDs) on outcome in 1) a medication trial for major depression (MD) and 2) a psychotherapy trial for MD.

Method:

Two treatment trials for patients with MD were performed: 1) randomized clinical trial of fluox-etine vs. nortriptyline with open follow-up (n = 195) and 2) randomized clinical trial of interpersonal psychotherapy (IPT) vs. cognitive behavioural therapy (n = 177).

Results:

Comorbid PD had no impact on the outcome of MD in patients treated with medication over the short term. Avoidant PD was associated with poorer outcome over the longer term. Comorbid PD had a negative impact on the outcome of MD in patients treated with psychotherapy over the short term. This was largely explained by the poor response to IPT in depressed patients with comorbid PD.

Discussion:

The finding that comorbid PD adversely affects the outcome in depressed patients treated with psychotherapy but not with drugs is consistent with other studies. Possible mechanisms are discussed.