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Personality pathology, depression and HPA axis functioning.

I. Schweitzer1, V. Tuckwell, K. Maguire

  • 1The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Melbourne, Australia.

Human Psychopharmacology
|October 31, 2002
PubMed
Summary
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Major depressive disorder (MDD) patients with higher personality pathology showed normal cortisol suppression on the dexamethasone suppression test (DST). This suggests distinct pathways in depression linked to personality versus biological factors.

Area of Science:

  • Psychiatry
  • Neuroendocrinology
  • Clinical Psychology

Background:

  • The hypothalamic pituitary adrenal (HPA) axis is frequently studied in major depressive disorder (MDD).
  • Investigating HPA axis function alongside personality disorders may elucidate depressive symptom origins.
  • The dexamethasone suppression test (DST) is a common measure of HPA axis activity.

Purpose of the Study:

  • To examine the relationship between personality pathology and HPA axis functioning in MDD patients.
  • To determine if specific personality disorder traits correlate with DST response in depression.

Main Methods:

  • Administered the Millon Clinical Multiaxial Inventory-II (MCMI-II) to assess personality pathology.
  • Assessed HPA axis function using the dexamethasone suppression test (DST) in 25 MDD patients.

Related Experiment Videos

  • Compared DST suppressors and non-suppressors on MCMI-II personality disorder scales.

    • Main Results:

    • Patients with normal DST suppression (suppressors) scored higher on six MCMI-II personality disorder scales.
    • These scales included Avoidant, Schizoid, Self-Defeating, Passive-Aggressive, Schizotypal, and Borderline personality disorders.
    • Increased personality pathology correlated with normal cortisol suppression after DST.

    Conclusions:

    • Depressive states associated with personality pathology may involve normal HPA axis suppression.
    • Depression with abnormal HPA pathophysiology might be linked to non-suppression on the DST.
    • Findings suggest distinct neurobiological and psychological underpinnings in MDD subtypes.