AN INVESTIGATION OF THE EFFECTS OF COMORBID AXIS-II PATHOLOGY ON OUTCOME OF INPATIENT TREATMENT FOR UNIPOLAR DEPRESSION

DSM-based research on comorbidity has suggested that depression and pe rsonality disorder frequently occur together and that the combination of syndromes is associated with a poor response to treatment for depre ssion. The present study was designed to explore the effect of comorbi d Axis II pathology for a sample of 45 inpatients who received treatme nt for major depression. Both categorical and dimensional ratings of p ersonality disorder were used in the statistical analysis. Positive ca tegorical diagnosis of Cluster C (anxious-avoidant) disorder as well a s higher dimensional rating of Cluster A (odd-eccentric) pathology, wa s predictive of a poor response to treatment (p <.05), as measured by change in pre-post clinical ratings on the Montgomery-Asberg Depressio n Rating Scale. These results were construed as indicative of a signif icant Axis II comorbidity effect in the context of an inpatient, multi modal treatment setting for depression. The results also spotlight the influence of techniques of measurement in determining the outcome of statistical analysis.