[Impact of personality factors in depression]

Patients meeting criteria for borderline personality disorder are heterogeneous. Our studies suggest that at least two sub-types exist which benefit from specific treatments. Data will be presented which suggests that some patients who meet borderline criteria and have atypical depression (patients meeting DSM III-R criteria for major depression or dysthymia reactive wills mood and any vegetative atypical symptoms, i.e. overeating, oversleeping, rejection sensitivity, leaden paralysis) clearly benefit from treatment with antidepressant medication. Although some patients with atypical depression who meet borderline criteria will improve with tricyclic therapy, a significantly greater proportion will improve with the monoamine oxidase inhibitor (MAOI) phenelzine if they suffer from atypical depression. The validity of emotionally unstable character disorder (EUCD) will also be examined. Patients with this disorder frequently meet criteria for borderline character disorder. The validity of this sub-group is supported by the presence of neurological soft signs, their negative response to anti-depressants, and their positive response to chlorpromazine and lithium.