Occurrence and effects of personality disorders in depression: are they the same in the old and young?

To determine the frequency and effects of personality disorders on episodes of depression in elderly and young inpatients. Personality disorders are common and may affect the prognosis of Axis I disorders.

Clinical records of 89 elderly inpatients and a matched comparison group of 119 young inpatients were reviewed to confirm the diagnosis of a major depressive episode according to the DSM-III-R criteria. The frequency of personality disorder diagnoses in the 2 groups was determined. Within each group, severity, functioning, and treatment were compared between those with and without personality disorders.

Personality disorders were diagnosed more frequently in the young (40.3%) than in the elderly (27%). Both rates were similar to previous reports. Cluster C disorders were the most common personality disorders found in the elderly, compared to cluster B disorders in the young. Personality disorder in the young was associated with longer episodes of depression (P = 0.035) and poorer family relations (P < 0.001); whereas in the elderly, personality disorder was associated with more severe episodes (P = 0.014).

These findings suggest that the frequency and effects of personality disorders on the depressed patient may differ according to age.