Life Events and Recurrent Depression in Borderline and Antisocial Personality Disorders

Abstract

The temporal relationship between life events and the recurrence of depression was ascertained in a prospectively followed sample of adults with borderline or antisocial personality disorders or bipolar type II affective disorder. The 8-week period of risk immediately following a life event was temporally associated with annualized rates of depression recurrence (depending on the definition) 1.9 to 2.9 times higher compared to periods when no life events occurred. Whether rated by self-report or by objective raters, more stressful events were associated with higher rates of depression. Events caused by the subject were also associated with higher rates of depression. The pathogenicity of interpersonal exit events was not significantly supported overall, but there were differential trends depending on personality psychopathology. Higher scores on the Borderline Personality Disorder Scale predicted higher recurrence rates of depressive symptoms and nonacute major depressive episodes following life events, especially those caused by the subject, and a trend for acute major depressive episodes following interpersonal exit (loss) events. Antisocial symptoms demonstrated a trend predicting higher depression recurrence rates by all three definitions following exit events. Overall, recurrent depression was highly reactive to the occurrence, severity, and meaning of life events in adults with personality disorders.