Personality disorder and functioning in major depressive disorder: a nested study within a randomized controlled trial

Abstract

Objective: This study aimed to determine if personality disorder (PD) predicted functional outcomes in patients with major depressive disorder (MDD). Methods: Data (n=71) from a double-blind, randomized, placebo-controlled 12-week trial assessing the efficacy of 200 mg/day adjunctive minocycline for MDD were examined. PD was measured using the Standardized Assessment of Personality Abbreviated Scale. Outcome measures included Clinical Global Impression-Improvement (CGI-I), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Social and Occupational Functioning Scale (SOFAS), and Range of Impaired Functioning (RIFT). Analysis of covariance was used to examine the impact of PD (dichotomized factor [X 3] or continuous measure) on the outcome measures-treatment group correlation. Results: PD was identified in 69% of the sample. After adjusting for age, sex, and baseline scores for each of the outcome measures, there was no significant difference between participants with and without PD on week 12 scores for any of the outcome measures (all p 4 0.14). Conclusion: In this secondary analysis of a primary efficacy study, PD was a common comorbidity among those with MDD, but was not a significant predictor of functional outcomes. This study adds to the limited literature on PD in randomized controlled trials for MDD. Clinical trial registration: ACTRN12612000283875.

Prognostic Significance of Personality Disorders in Patients with Major Depressive Disorder

“…A secondary analysis of the primary efficacy study showed that PD was a common comorbidity among patients with MDD. In this relatively small sample, PD was not found to be a significant predictor of functional outcomes [6].…”

The Influence of Personality Disorder Symptoms on Treatment Outcomes in Bipolar Disorder: A Secondary Analysis of a Randomised Controlled Trial: L’influence des symptômes du trouble de la personnalité sur les résultats du traitement dans le trouble bipolaire : Une analyse secondaire d’un essai randomisé contrôlé

“…This method has been used in similar studies investigating the influence of PD on mood disorder outcomes. 27 The MADRS total score was the primary interviewerrated outcome for the overarching trial. 25 Bipolar depression symptom severity was also measured using interviewer-rated Bipolar Depression Rating Scale (BDRS).…”

The importance of assessing personality traits and disorders in clinical trials of major depressive disorder

“…In summary, current evidence regarding the effects of co-occurring PDs on treatment response in MDD remains limited, and the majority of published RCTs have not presented data on this relevant aspect. Although Kavanagh et al 8 have added to the current evidence base, we suggest that future RCTs of emerging treatments in MDD include a robust assessment of PD in the form of structured diagnostic interviews. In addition, the design of large multicenter RCTs could further elucidate the role of co-occurring personality traits and disorders in MDD treatment outcomes.…”

“…7 Given the high prevalence of comorbid PD and MDD and the conflicting evidence on whether this contributes to treatment resistance, we propose that a structured assessment of personality traits and disorders could be incorporated in RCTs of interventions for MDD. The study by Kavanagh et al 8 in the current issue was designed to provide such information. This study presents a post-hoc analysis of the association between PD diagnosis and treatment response in a RCT of the anti-inflammatory tetracycline antibiotic minocycline as an augmenting agent in MDD.…”