Borderline Personality Disorder and Age of Onset in Major Depression

Rothschild, Louis; Zimmerman, Mark

doi:10.1521/pedi.16.2.189.22551

Cited by 14 publications

(11 citation statements)

References 22 publications

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“…The first of these results is important because it means that treatment rates are increasing over time. The second result is also important because it suggests that early onset cases, which are often more persistent and severe than later-onset cases (Rothschild and Zimmerman, 2002), have the longest delays in obtaining treatment. Some limited information about the generalizability of this pattern was obtained by including questions about age of onset and speed of initial treatment contact in a cross-national survey of members of patient advocate groups in 11 countries around the world.…”

Section: Speed Of Initial Treatment Contactmentioning

confidence: 99%

The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys

Andrade

Caraveo-Anduaga

Berglund

et al. 2003

Int J Methods Psych Res

929

596

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Absence of a common diagnostic interview has hampered cross-national syntheses of epidemiological evidence on major depressive episodes (MDE). Community epidemiological surveys using the World Health Organization Composite International Diagnostic Interview administered face-to-face were carried out in 10 countries in North America (Canada and the US), Latin America (Brazil, Chile, and Mexico), Europe (Czech Republic, Germany, the Netherlands, and Turkey), and Asia (Japan). The total sample size was more than 37,000. Lifetime prevalence estimates of hierarchy-free DSM-III-R/DSM-IV MDE varied widely, from 3% in Japan to 16.9% in the US, with the majority in the range of 8% to 12%. The 12-month/lifetime prevalence ratio was in the range 40% to 55%, the 30-day/12-month prevalence ratio in the range 45% to 65%, and median age of onset in the range 20 to 25 in most countries. Consistent socio-demographic correlates included being female and unmarried. Respondents in recent cohorts reported higher lifetime prevalence, but lower persistence than those in earlier cohorts. Major depressive episodes were found to be strongly co-morbid with, and temporally secondary to, anxiety disorders in all countries, with primary panic and generalized anxiety disorders the most powerful predictors of the first onset of secondary MDE. Major depressive episodes are a commonly occurring disorder that usually has a chronic-intermittent course. Effectiveness trials are needed to evaluate the impact of early detection and treatment on the course of MDE as well as to evaluate whether timely treatment of primary anxiety disorders would reduce the subsequent onset, persistence, and severity of secondary MDE.

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Section: Speed Of Initial Treatment Contactmentioning

confidence: 99%

The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys

Andrade

Caraveo-Anduaga

Berglund

et al. 2003

Int J Methods Psych Res

929

596

View full text Add to dashboard Cite

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“…Patients with early onset depression were likely to have more previous depressive episodes, a longer current depressive episode and greater comorbidity than patients with late onset depression (Klein et al, 1999;Rothschild and Zimmerman, 2002).…”

Section: Introductionmentioning

confidence: 98%

Temperament and character as predictors of recurrence in remitted patients with major depression: A 4-year prospective follow-up study

Asano

Baba

Kawano

et al. 2015

Psychiatry Research

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“…Further, Cyranowski and others treated patients suffering from depression with IPT and found that subjects meeting criteria for a personality disorder more frequently needed adjunctive SSRI treatment to achieve remission of depressive episodes (16). Although this comorbidity is very common (53% to 85% in BPD samples) (27)(28)(29)(30)(31) and exerts significant effects on severity of depression and social impairment (27,32,33), there are currently no studies that focus on combined treatment of major depression that affects patients with BPD. The use of psychotherapy in treating these patients is central to the investigation of this topic.…”

mentioning

confidence: 99%

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

et al. 2006

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Objective: Combined treatment with psychotherapy and antidepressants is more effective than monotherapies. Recent data show that combined therapy has better results in patients with depression and Axis II codiagnosis. The aim of this study was to compare combined treatment using interpersonal psychotherapy (IPT) with pharmacotherapy alone in patients with depression and borderline personality disorder (BPD).Methods: There were 39 consecutive outpatients diagnosed with BPD who presented with a major depressive episode enrolled in this study. They were randomly assigned to 1 of 2 treatment groups: fluoxetine 20 mg to 40 mg daily or fluoxetine 20 mg to 40 mg daily plus IPT 1 session weekly. Owing to noncompliance, 7 patients dropped out. We assessed the 32 patients who completed the 24 weeks of treatment at baseline, Week 12, and Week 24, using a semistructured interview for clinical characteristics, the Clinical Global Impression Scale (CGI), the Hamilton Depression Rating Scale (HDRS), and the Hamilton Anxiety Rating Scale (HARS), and 2 self-report questionnaires, that is, the Satisfaction Profile (SAT-P) for quality of life and the 64-item Inventory for Interpersonal Problems (IIP-64). We performed statistical analysis, using univariate general linear models with 2 factors: duration and type of treatment.Results: Changes in remission rates, CGI, and HARS score did not differ between treatments. According to changes in the HDRS scores; changes in psychological functioning and social functioning scores on the SAT-P; and changes in vindictive or self-centred, cold or distant, intrusive or needy, and socially inhibited scores on the IIP-64, combined therapy was superior to fluoxetine alone. Conclusions:Combined therapy with IPT is more effective than antidepressant therapy alone, both in treating symptoms of major depression and in improving dimensions of quality of life and interpersonal functioning. Clinical implications· Combining fluoxetine and IPT is a more effective treatment of major depression symptoms in patients with BPD than fluoxetine alone. · Combined treatment produces more significant improvements in quality of life and interpersonal functioning in patients with BPD suffering from depression. · Combined therapy with fluoxetine and IPT can be considered a treatment of choice for major depression with BPD. Limitations· The sample size was relatively small; thus, conclusive statements cannot be made. · We did not compare combined therapy and IPT alone. · Follow-up data on recurrences of major depressive episodes have not yet been analyzed.

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Borderline Personality Disorder and Age of Onset in Major Depression

Cited by 14 publications

References 22 publications

The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys

The epidemiology of major depressive episodes: results from the International Consortium of Psychiatric Epidemiology (ICPE) surveys

Temperament and character as predictors of recurrence in remitted patients with major depression: A 4-year prospective follow-up study

Combined Treatment of Major Depression in Patients with Borderline Personality Disorder: A Comparison with Pharmacotherapy

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