M. Fava et al., PATTERNS OF PERSONALITY-DISORDER COMORBIDITY IN EARLY-ONSET VERSUS LATE-ONSET MAJOR DEPRESSION, The American journal of psychiatry, 153(10), 1996, pp. 1308-1312
Objective: This study tested the hypothesis that in a population of ad
ult outpatients with major depression, those with an early onset of de
pression would have a greater prevalence of personality disorders than
those with a late onset of depression. Method: The 404 subjects weve
patients participating in depression treatment studies at the Massachu
setts General Hospital. They were administered the Structured Clinical
Interview for DSM-III-R-Patient Version to assess the current presenc
e of major depression and the age at onset of the initial depressive e
pisode. The subjects were then divided into two groups: those with ear
ly onset (before 18 years of age) and those with late onset (at age 18
or later). The prevalence of personality disorders was determined thr
ough use of the physician-rated Structured Clinical Interview for DSM-
III-R Personality Disorders (SCID-II) and the patient-rated Personalit
y Diagnostic Questionnaire-Revised (PDQ-R). Results: The patients with
early onset of major depression had a significantly higher prevalence
of avoidant, histrionic, narcissistic, and borderline personality dis
orders according to the SCID-II. The PDQ-R scores indicated that avoid
ant, dependent, passive-aggressive, histrionic, narcissistic, borderli
ne, and antisocial personality disorders were significantly more preva
lent among the patients with early onset of major depression. Conclusi
ons: Overall, the results are consistent with the view that early-onse
t depressive illness is distinguished from late-onset major depression
by more frequent association with persistent disturbances in behavior
s and attitudes.