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Treatment-resistant depression and Axis II comorbidity
Timothy Petersen1, Megan Hughes, George I Papakostas
1Depression Clinical and Research Program, Massachusetts General Hospital, Boston, Mass 02114, USA. tpetersen@partners.org
Psychotherapy and Psychosomatics
|September 11, 2002
Summary
Treatment resistance in depression was not linked to higher rates of personality disorders in this study. Researchers found no significant differences in Axis II disorders between treatment-resistant and non-treatment-resistant depressed patients.
Area of Science:
- Psychiatry
- Clinical Psychology
- Mental Health Research
Background:
- Personality disturbance is a suspected factor in treatment-resistant depression.
- This study investigated Axis II disorder prevalence in treatment-resistant depression (TRD).
Purpose of the Study:
- To compare Axis II disorder prevalence between TRD and non-TRD outpatients.
- To determine if personality disorders contribute to antidepressant treatment resistance.
Main Methods:
- Structured Clinical Interview for DSM-III-R Personality Disorders used for assessment.
- 53 TRD and 105 non-TRD patients were recruited and matched for depression severity and gender.
- Chi-square and t-tests analyzed demographic and clinical variables.
Main Results:
- No statistically significant differences in Axis II disorders were found between TRD and non-TRD groups.
- Obsessive-compulsive personality disorder was more frequent in non-TRD patients, but not significantly.
- Axis II comorbidity ranged from 0.0-30.2% in TRD and 2.9-37.1% in non-TRD patients.
Conclusions:
- Treatment resistance in major depressive episodes was not associated with increased Axis II disorders in this sample.
- Strengths include structured diagnostic tools and matched groups.
- Limitations include sample size and reliance on DSM personality constructs.