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Cited by 225Personality Disorders and PsychopathologyPersonality Traits and PsychologyBipolar Disorder and Treatment

Relationship of Personality Disorders to the Course of Major Depressive Disorder in a Nationally Representative Sample

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Skodol, Andrew E., Grilo, Carlos M., Keyes, Katherine M., Geier, Timothy, Grant, Bridget F., Hasin, Deborah S.·2011·American Journal of Psychiatry
DOI 10.1176/appi.ajp.2010.10050695PMC PMC3202962
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Abstract

OBJECTIVE: The purpose of this study was to examine the effects of specific personality disorder comorbidity on the course of major depressive disorder in a nationally representative sample. METHOD: Data were drawn from 1,996 participants in a national survey. Participants who met criteria for major depressive disorder at baseline in face-to-face interviews (in 2001-2002) were reinterviewed 3 years later (in 2004-2005) to determine persistence and recurrence. Predictors included all DSM-IV personality disorders. Control variables included demographic characteristics, other axis I disorders, family and treatment histories, and previously established predictors of the course of major depressive disorder. RESULTS: A total of 15.1% of participants had persistent major depressive disorder, and 7.3% of those who remitted had a recurrence. Univariate analyses indicated that avoidant, borderline, histrionic, paranoid, schizoid, and schizotypal personality disorders all elevated the risk for persistence. With axis I comorbidity controlled, all personality disorders except histrionic personality disorder remained significant. With all other personality disorders controlled, borderline and schizotypal disorders remained significant predictors. In final, multivariate analyses that controlled for age at onset of major depressive disorder, the number of previous episodes, duration of the current episode, family history, and treatment, borderline personality disorder remained a robust predictor of major depressive disorder persistence. Neither personality disorders nor other clinical variables predicted recurrence. CONCLUSIONS: In this nationally representative sample of adults with major depressive disorder, borderline personality disorder robustly predicted persistence, a finding that converges with recent clinical studies. Personality psychopathology, particularly borderline personality disorder, should be assessed in all patients with major depressive disorder, considered in prognosis, and addressed in treatment.

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  • MDD was associated with other psychiatric disorders, especially generalized anxiety disorder and borderline personality disorder.

    “Major depressive disorder was associated with other psychiatric disorders, especially generalized anxiety disorder and borderline personality disorder, associations found in previous studies.5,[46][47][48][49]”

    From Epidemiology of Adult <i>DSM-5</i> Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [48]

    The Introduction describes major depressive disorder as comorbid with other mental disorders, and the Results and Discussion identify borderline personality disorder and anxiety disorders as relevant to its persistence. The paper does not single out generalized anxiety disorder as an especially strong association; the Results instead name specific phobia and panic disorder as predictors of persistence. Its main finding concerns the course of MDD, not a ranking of disorders associated with MDD generally. (LLM, conf=0.85)

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Research works printed but not linked: 1

  1. [19]Cohen P Cohen J The clinician’ illusion Arch Gen Psychiatry 1984 41 1178 1182 6334503

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Authors
Skodol, A. E., Grilo, C. M., Keyes, K. M., Geier, T., Grant, B. F., & Hasin, D. S.
Affiliations
New York State Psychiatric Institute (US)
ORCID
Venue
American Journal of Psychiatry
Publisher
American Psychiatric Association Publishing
Published
2011-03
Volume
168
Issue
3
Pages
257-264
ISSN
  • 0002-953X (ISSN-L)
  • 1535-7228
DOI
10.1176/appi.ajp.2010.10050695
PMC
PMC3202962
OpenAlex
W2158522650
Cited by
225
References
40
Citations by year
2026: 7 · 2025: 10 · 2024: 12 · 2023: 6 · 2022: 19 · 2021: 20 · 2020: 12 · 2019: 13 · 2018: 18 · 2017: 18 · 2016: 14 · 2015: 14 · 2014: 23 · 2013: 17 · 2012: 12
FWCI
21.41
Type
journal article
Language
en
Open access
Locations
  • American Journal of Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health
  • National Institute on Alcohol Abuse and Alcoholism (Z01AA000449, U01AA018111, K05AA014223)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
major depressive disorder, personality disorders, borderline personality disorder, schizotypal personality disorder, disease persistence, recurrence, comorbidities, prognosis, DSM-IV personality disorders, avoidant personality disorder, histrionic personality disorder, paranoid personality disorder, schizoid personality disorder
MeSH terms
Adult, Depressive Disorder, Major, Major Depressive Disorder, Female, Health Surveys, Humans, Male, Middle Aged, Personality Disorders, Prognosis, Recurrence, Risk Factors, Comorbidity

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