Personality disorder, symptoms and dexamethasone suppression in depression

The presence of Personality Disorder (PD) in depressed patients admitted to the acute wards of a psychiatric hospital was assessed using Tyrer's Personality Assessment Schedule, and its relationship to depressive symptoms, improvement after 2 weeks, and the dexamethasone suppression test was examined. 75.4% of the sample met Tyrer's criteria for a PD diagnosis. The initial symptoms of patients with personality disorder did not differ from those without PD. However patients with PD improved more slowly, and had significantly higher symptom scores after 2 weeks. Patients with PD also showed previous history of more depressive episodes, a younger first age of onset, and more frequent and severe previous suicide attempts, in addition to history of unstable marriage. No difference in dexamethasone suppression was found. These findings suggest that presence of personality disorder is related primarily to course of illness and life history, rather than symptom pattern.