UNSTABLE PERSONALITY-DISORDERS - PROGNOSTIC IMPLICATIONS FOR MAJOR DEPRESSION

Sixty-nine depressed inpatients assessed for DSM-III personality disor ders (PDs) were followed up after 4 years. Patients With unstable PDs (USPD; borderline, narcissistic, histrionic, and antisocial PDs) were compared with all other depressives. Considering patients of all ages, USPD was unrelated to course and weakly related to suicidal behavior. In post hoc analyses, patients were divided into ''younger'' (aged 18 -25) and ''older'' (over 25). USPD but not other PDs predicted more ep isodes of depression. more manipulative suicidal behavior, and more me dically serious suicide attempts among older depressives. USPD was unr elated to prognosis among younger depressives. This may be because man y young USPDs will reach higher levels of adaptive functioning over se veral years, whereas USPDs still requiring hospitalization beyond thei r mid-20s tend to have more intractable character pathology with poore r long-term prognosis.