Major depression and dimensional representations of DSM-IV personality disorders: a population-based twin study
Open accessAbstract
Background: Major depressive disorder (MDD) co-occurs frequently with personality disorders (PDs). The extent to which this results from shared genetic or environmental risk factors remains uncertain. Method: Young adult twins (n=2801) from the population-based Norwegian Institute of Public Health Twin Panel were assessed at personal interview for DSM-IV lifetime MDD and the 10 Axis II PDs. The relationship between MDD and dimensional representations of all PDs was explored by stepwise logistic regression. Multivariate Cholesky twin models were fitted using the Mx program, and genetic and environmental correlations were estimated. Results: Dimensional representations of borderline (BPD), avoidant (AVPD) and paranoid personality disorder (PPD) were independently and significantly associated with increased risk for MDD. Multivariate twin modeling indicated that one latent factor accounted for the genetic covariance between MDD and the three PDs. The genetic correlations between MDD and dimensional representations of BPD, AVPD and PPD were +0.56, +0.22 and +0.40 respectively. No sex differences or shared environmental effects were found. The structure of the individual-specific environmental factors influencing MDD and the three PDs were similar to the genetic factors but the environmental correlations were lower: +0.39, +0.23 and +0.27 respectively. Conclusions: There is substantial overlap between liability factors for MDD and BPD from cluster B, PPD from cluster A and AVPD from cluster C. The vulnerability to general PD pathology and MDD seem to be closely related. The patterns of co-morbidity observed between diverse psychiatric disorders might result from just a few liability factors.
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Adjusting for mood and anxiety disorders may be overly conservative because personality disorder symptoms overlap with anxiety and depression, potentially underestimating the true effects of personality disorders.
“The symptoms might therefore work as mediators instead of confounders, making the adjustments overly conservative and underestimating the true effects of PDs.”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [36]
Personality disorders are highly co-morbid with anxiety and depression, and these disorders are known to be associated with increased risk of disability pensioning.
“PDs are highly co-morbid with anxiety and depression [35–38], and these disorders are known to be associated with an increased risk of disability pensioning [3–6].”
From Personality disorders are important risk factors for disability pensioning (2014) · cites this paper as [36]
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Personality disorders are important risk factors for disability pensioning
Østby, K. A., Czajkowski, N., Knudsen, G. P., Ystrom, E., Gjerde, L. C., Kendler, K. S., Ørstavik, R. E., & Reichborn-Kjennerud, T. (2014) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-014-0878-0 · Cited by 72 · see citing works
“PDs are highly co-morbid with anxiety and depression [35–38], and these disorders are known to be associated with an increased risk of disability pensioning [3–6].”
Self-citationZheng, Y., Severino, F., Hui, L., Wu, H., Wang, J., & Zhang, T. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00833 · Cited by 26 · see citing works
- Authors
- Reichborn-Kjennerud, T., Czajkowski, N., Røysamb, E., Ørstavik, R. E., Neale, M. C., Torgersen, S., & Kendler, K. S.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Virginia Commonwealth University (US)
- University of Oslo (NO)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-11-17
- Volume
- 40
- Issue
- 9
- Pages
- 1475-1484
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- PMC
- PMC2909484
- OpenAlex
- W1995336284
- Cited by
- 61
- References
- 45
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 7 · 2019: 5 · 2018: 4 · 2017: 6 · 2016: 3 · 2015: 5 · 2014: 8 · 2013: 4 · 2012: 10
- FWCI
- 3.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH-068643, R01MH068643, R01MH065322, MH 65322)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- major depressive disorder, personality disorders, borderline personality disorder, avoidant personality disorder, paranoid personality disorder, genetic correlation, environmental correlation, shared liability, comorbidities, twin studies
- MeSH terms
- Adult, Borderline Personality Disorder, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Norway, Paranoid Personality Disorder, Personality Disorders, Risk Factors, Comorbidity, Prevalence, Multivariate Analysis, Logistic Models, Diagnostic and Statistical Manual of Mental Disorders
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