THE EDINBURGH PRIMARY-CARE DEPRESSION STUDY - PERSONALITY-DISORDER AND OUTCOME

Background. Little is known about the impact of personality pathology on the treatment outcome of major depressive illness in primary care i n the UK. Method. Patients meeting criteria for DSM-III major depressi ve disorder were randomly allocated to one of four treatments each las ting 16 weeks, then followed up for 18 months. Assessments were made o f depressive symptoms, personality and social functioning. Personality was assessed at maximum improvement or 16 weeks. Results. The prevale nce of personality disorder (PD) in the sample of 113 patients was 26% . Patients with a PD were significantly younger and rated more depress ed at entry than patients with no personality disorder (NoPD). On comp letion of treatment patients with a PD were significantly more depress ed and had poorer social functioning than the NoPD group. After 18 mon ths there were no differences in ratings of depression or social funct ioning between the groups. Conclusions. There was substantial improvem ent in both the PD and NoPD groups. The presence of personality pathol ogy delays recovery from major depressive illness.