Abstract
Introduction: It is common that personality disorder (PD) co-occurs with major depressive disorder (MDD). In the current literature, there is a dearth of information on the co-occurrence of PD and MDD among Chinese population. Materials and Methods: 609 individuals were randomly sampled from outpatients diagnosed as MDD in Shanghai Mental Health Center. Co-morbidity of PDs was assessed using the Personality Diagnostic Questionnaire Fourth Edition Plus (PDQ-4+) and eligible subjects were interviewed with the Structured Clinical Interview for DSM-IV Axis II (SCID-II). The score of PDQ-4+ and the rate of SCID-II PD between subjects diagnosed with MDD and those with anxiety disorders (AD) were compared. Results: Two hundred fifty-eight outpatients (42.36%) with MDD were recognized to possess at least one criterion of diagnosis for PD, according to the DSM-IV. The most prevalent PD was depressive PD (14.61%), followed by avoidant (11.49%) and borderline (11.49%) PD. Cluster C PDs (anxious and panic PD) were the most common PD types (12.12%) when compared to other clusters. Compared to patients with AD, individuals with MDD were significantly more likely to have paranoid PD (6.6% vs. 3.3%, p = 0.011), borderline PD (11.5% vs. 3.7%, p = 0.000), passive-aggressive PD (5.6% vs. 2.4%, p = 0.007), and depressive PD (14.6% vs. 7.8%, p = 0.000). Discussion: The finding indicates that there is a high prevalence of PD among patients with MDD. More significant co-morbidity rates of PDs in MDD have been found when compared with AD. Further studies for the longitudinal impact of the PD-MDD co-morbidity are in need.
Highlights
It is common that personality disorder (PD) co-occurs with major depressive disorder (MDD)
The results significantly showed the prevalence of PD among patients with MDD with lower occurrence rates than the PDQ-4+ results
The results evaluated by interviews showed that borderline and depressive PDs were significant predictors of MDD
Summary
It is common that personality disorder (PD) co-occurs with major depressive disorder (MDD). Personality disorder (PD) with major depressive disorder (MDD) has been one of the most common co-morbidities in mental health disorders [1, 2]. It has been generally recognized that the chronicity of depression is related with a longer duration of untreated illness (DUI) [7], which might be influenced by many indicators [8] This underlines the necessity of considering the impact of the influential factors with poorer prognosis and incorporate specific interventions toward PD, including pharmacological [9,10,11], psychological [12,13,14,15,16], and social interventions [17]. The most frequently co-occurred PD subtypes were in turn: avoidant, borderline, dependent, obsessive-compulsive [24], and self-defeating PDs [1]
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