Select comorbid personality disorders and the treatment of chronic depression with nefazodone, targeted psychotherapy, or their combination
Abstract
Background Individuals with chronic depression respond poorly to both medication and psychotherapy. The reasons for the poorer response, however, remain unclear. One potential factor is the presence of comorbid Axis II personality disorders (PDs), which occur at high rates among these patients. Methods This study examines the moderating influence of co-occurring PDs, primarily in cluster C, among 681 chronically depressed adult outpatients who were randomly assigned to 12 weeks of treatment with nefazodone, a specialized psychotherapy for chronic depression, or their combination. Results At baseline, 50.4% (n=343) of patients met criteria for one or more Axis II disorders. Following 12 weeks of treatment, patients with comorbid PDs had statistically lower depression scores (M=12.2, SD=+9.2) than patients without comorbid PDs (M=13.5, SD=+8.7). There was no differential impact of a comorbid PD on responsiveness to medication versus psychotherapy. The results did not change when the data were analyzed using an intent-to-treat sample or when individual personality disorders were examined separately. Limitations Patients with severe borderline, antisocial, and schizotypal PDs were excluded from study entry; therefore, these data primarily apply to patients with cluster C PDs and may not generalize to other Axis II conditions. Conclusions Comorbid Axis II disorders did not negatively affect treatment outcome and did not differentially affect response to psychotherapy versus medica…
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A study found that at follow-up both schema therapy and metacognitive therapy significantly decreased depression and anxiety, but there was no significant difference between the methods (Maddux et al., 2009).
“They found that at the fallow-up stage both methods of schema therapy and metacognitive therapy had significantly decreased depression and anxiety; however, at the follow-up stage, there was no significant difference between the methods (Maddux et al., 2009).”
From Comparison of the Effectiveness of Schema Therapy and Acceptance and Commitment Therapy on Depression and Anxiety in Students of Hormozgan University of Medical Sciences, Iran (2019) · cites this paper as Maddux et al., 2009
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Self-citationMaffei, C., Fossati, A., Agostoni, I., Barraco, A., Bagnato, M., Deborah, D., Namia, C., Novella, L., & Petrachi, M. (1997) · Journal of Personality Disorders · doi:10.1521/pedi.1997.11.3.279 · Cited by 516 · see citing works
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Self-citationKlein, D. N., Shankman, S. A., & Rose, S. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.5.872 · Cited by 194 · see citing works
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Personalized Medicine for Depression: Can We Match Patients With Treatments?
Simon, G. E., & Perlis, R. H. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09111680 · Cited by 365 · see citing works
A review of empirically supported psychological therapies for mood disorders in adults
Hollon, S. D., & Ponniah, K. (2010) · Depression and Anxiety · doi:10.1002/da.20741 · Cited by 267 · see citing works
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- Authors
- Maddux, R. E., Riso, L. P., Klein, D. N., Markowitz, J. C., Rothbaum, B. O., Arnow, B. A., Manber, R., Blalock, J. A., Keitner, G. I., & Thase, M. E.
- Affiliations
- Lund University (SE)
- Argosy University (US)
- Stony Brook University (US)
- Cornell University (US)
- Emory University (US)
- Stanford Medicine (US)
- The University of Texas System (US)
- Brown University (US)
- University of Pennsylvania (US)
- Corresponding author
- Riso, Lawrence P.
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2009-10
- Volume
- 117
- Issue
- 3
- Pages
- 174-179
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1968957753
- Cited by
- 40
- References
- 5
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 3 · 2016: 6 · 2014: 4 · 2013: 4 · 2012: 5
- FWCI
- 4.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- chronic depression, personality disorders, comorbidities, nefazodone, treatment response, cluster C personality disorders, antidepressant treatment, psychotherapy
- MeSH terms
- Adaptation, Psychological, Adult, Chronic Disease, Combined Modality Therapy, Culture, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Personality Disorders, Personality Inventory, Piperazines, Problem Solving, Recurrence, Triazoles, Comorbidity, Cognitive Behavioral Therapy, Antidepressive Agents, Second-Generation, Dysthymic Disorder
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