Impact of Cluster C Personality Disorders on Outcomes of Acute and Maintenance Treatment in Late-Life Depression

Abstract

Personality disorders (PDs) have been associated with poor treatment outcomes in acute treatments for late-life depression and with persistent functional impairment after recovery from an episode of depression. Using survival analysis and mixed-effects models, the authors examined the impact of Cluster C PDs on time-to-response and several aspects of functioning in acute and maintenance treatment of major depression in later life. Cluster C PDs were associated with longer time-to-response during acute treatment and non-response in continuation or maintenance treatment. Although not statistically significant, there was evidence of a cumulative negative impact of Cluster C PDs and residual depressive symptoms on instrumental activities of daily living (IADLs) during maintenance treatment. These findings suggest that screening for PD may be important for clinicians treating late-life depression and that the combination of Cluster C PDs and residual depressive symptoms may predict functional declines even after recovery from the index episode of depression.