Childhood depression and adult personality disorder - Alternative pathwaysof continuity

Background: This study extends previous findings of the risks posed by chil dhood major depressive disorder and other psychopathological features for l ater personality disorder (PD) in a random sample of 551 youths. Methods: Self-reports and mother reports were used to evaluate DSM-III-R (A xes I and II) psychiatric disorders at mean ages of 12.7, 15.2, and 21.1 ye ars. Logistic regression was used to examine the independent effects of maj or depressive disorder in childhood or adolescence on 10 PDs in young adult hood. Results: Odds of dependent, antisocial, passive-aggressive, and histrionic PDs increased by more than 13, 10, 7, and 3 times, respectively, given prio r major depressive disorder. Those effects were independent of age, sex, di sadvantaged socioeconomic status, a history of child maltreatment, nonintac t family status, parental conflict, preexisting PD in adolescence, and othe r childhood or adolescent Axis I psychopathological features, including dis ruptive and anxiety disorders. In addition, odds of schizoid and narcissist ic PD increased by almost 6 times and odds of antisocial PD increased by al most 5 times given a prior disruptive disorder, and odds of paranoid PD inc reased by 4 times given a prior anxiety disorder. Conclusion: Personality disorders may represent alternative path ways of co ntinuity for major depressive disorder and other Axis I disorders across th e child-adult transition.