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Are personality assessments valid in acute major depression?
S Stuart1, A D Simons, M E Thase
1Department of Psychiatry, University of Pittsburgh School of Medicine, Pennsylvania 15213.
Journal of Affective Disorders
|April 1, 1992
Summary
Deferring personality disorder assessment in depressed patients is crucial. Initial diagnoses may not be valid due to depression
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Axis II comorbidity in depressed patients can impact treatment and prognosis.
- Depression may compromise the validity of personality disorder diagnoses due to recall bias.
Purpose of the Study:
- To investigate the validity of Axis II personality disorder diagnoses in acutely depressed patients.
- To determine if personality disorder diagnoses change after effective treatment for depression.
Main Methods:
- Studied 53 acutely depressed unipolar outpatients using the Personality Disorder Examination (PDE).
- Assessed patients before and after cognitive behavior therapy (CBT).
Main Results:
- Pretreatment PDE diagnoses showed no significant association with demographics, symptoms, illness course, or treatment response.
- Most pretreatment PDE diagnoses were not confirmed after successful CBT treatment.
Conclusions:
- Definitive Axis II assessment should be deferred until acute depressive episodes are optimally treated.
- Depression can significantly affect the accuracy of personality disorder assessments.