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Personality traits and disorder in depression

D S Charney, J C Nelson, D M Quinlan

    The American Journal of Psychiatry
    |December 1, 1981
    PubMed
    Summary

    Personality disorder is more prevalent in unipolar nonmelancholic depression, correlating with earlier onset and poorer outcomes in this group. Differentiating personality traits from disorders is crucial for accurate depression assessment.

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    Area of Science:

    • Psychiatry
    • Clinical Psychology
    • Mental Health Research

    Background:

    • Depression is heterogeneous, with subtypes like melancholic and nonmelancholic unipolar, and bipolar depression.
    • Personality factors are increasingly recognized as influencing depressive illness course and presentation.
    • Understanding the interplay between personality traits, personality disorders, and depressive subtypes is essential for effective treatment.

    Purpose of the Study:

    • To investigate the association between personality traits and personality disorders with depressive subtypes.
    • To examine the impact of personality factors on descriptive characteristics and treatment outcomes in depressed inpatients.
    • To evaluate the clinical utility of distinguishing between personality traits and personality disorders in the assessment of depression.

    Main Methods:

    • A cohort of 160 depressed inpatients was assessed for personality traits and personality disorders.
    • Patients were categorized into unipolar melancholic, unipolar nonmelancholic, and bipolar depressive subtypes.
    • Data on symptom manifestation, onset, and outcome were collected and analyzed in relation to personality variables.

    Main Results:

    • Personality disorder was significantly more common in unipolar nonmelancholic depressed patients (61%) compared to unipolar melancholic (14%) and bipolar depressed patients (23%).
    • Personality disorder was linked to earlier onset and worse outcomes specifically within the unipolar nonmelancholic group, but did not influence symptom presentation.
    • Obsessive traits were prevalent in melancholic patients, whereas histrionic, hostile, and borderline traits were more common in nonmelancholic patients.

    Conclusions:

    • Personality disorders are differentially distributed across depressive subtypes, being most frequent in unipolar nonmelancholic depression.
    • The presence of a personality disorder is associated with a more severe illness course (earlier onset, poorer outcome) in unipolar nonmelancholic depression.
    • A multiaxial diagnostic approach, differentiating personality traits from disorders, offers valuable insights for understanding and managing depression.

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