The impact of clinically diagnosed personality disorders on acute and one-year outcomes of electroconvulsive therapy

Clinical experience suggests that patients with depression and a comorbid p ersonality disorder (PD) may have a poorer response to electroconvulsive th erapy (ECT). Only a few published studies have examined the relationship be tween comorbid personality disorders and response of major depression to EC T. These studies have used relatively small numbers of patients. The presen t study is a retrospective review of 107 inpatients with a major depressive episode referred for ECT. Patients with a clinically diagnosed PD, especia lly a cluster B PD, had a significantly poorer acute response to ECT than t hose without a PD. During the first year after treatment, ECT responders wi th a comorbid PD had a higher rate of relapse of depression. The retrospect ive study design limits the strength of conclusions that can be drawn. Neve rtheless, it appears that clinically diagnosed PDs may be predictive of poo r outcome in patients receiving ECT for depression. Further prospective stu dy of the relationship between both clinically diagnosed PDs and structured interview based PD diagnoses and ECT treatment response is warranted.