On the conceptualisation of subaffective personality disorders

The reconceptualisation of German traditional constructs of subaffective personality disorders (PDs) was stimulated by clinical and some empirical evidence of mild and enduring alterations of mood and drive in patients who never developed one of the full-blown mood disorders. The aim of the study was to clarify the status of historical concepts of subaffective PDs (as there are the depressive, hyperthymic, cyclothymic, and asthenic type) in relation to the modern Diagnostic and Statistical Manual (DSM)-III-R conceptions of personality disorders and the five factor theory of personality. A consecutive psychiatric sample and a normal control sample were used to investigate these relationships. By means of a non-metric multi-dimensional scaling procedure, and facet theoretical interpretation, the depressive and asthenic PDs were demonstrated to correspond highly with the global construct of PD as well as with the personality factor neuroticism which proved to be elevated in most types of PDs within the clinical sample. The hyperthymic and cyclothymic categories displayed differences to most DSM-III-R constructs of PD in the clinical but not in the control sample. The findings may explain the chronic course of some depressive or somatization disorders that are difficult to influence by pharmacotherapy and that may require special treatment strategies.