Abstract
Background Despite extensive research, there is no consensus how Personality Disorders (PD) and PD features affect outcome for Major Depressive Disorder (MDD). The present study evaluated the effects of PD (features) on treatment continuation and effectiveness in Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for MDD. Methods Depressed outpatients were randomized to CT (n=72) and IPT (n=74). Primary outcome was depression severity measured repeatedly with the Beck Depression Inventory-II (BDI-II) at baseline, three months, at the start of each therapy session, at post-treatment and monthly during five months follow-up. Results Comorbid PD and PD features did not affect dropout. Multilevel and Cox regression models indicated no negative effect of PD on BDI-II change and remission rates during treatment and follow-up, irrespective of the treatment received. For both therapies, higher dependent PD features predicted overall lower BDI-II scores during treatment, however this effect did not sustain through follow-up. Cluster A PD features moderated treatment outcome during treatment and follow-up: individuals with high cluster A PD features had greater BDI-II reductions over time in CT as compared to IPT. Limitations Not all therapists and participants were blind to the assessment of PD (features), and assessments were performed by one rater. Further research must investigate the state and trait dependent changes of PD and MDD over time. Conclusions We found no negative impact of PD on the effectiveness and treatment retention of CT and IPT for MDD during treatment and follow-up. If replicated, cluster A PD features can be used to optimize treatment selection.
Original language | English |
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Pages (from-to) | 530-538 |
Number of pages | 9 |
Journal | Journal of Affective Disorders |
Volume | 225 |
Early online date | 17 Aug 2017 |
DOIs | |
Publication status | Published - 1 Jan 2018 |
Funding
This research was funded by the Research Institute of Experimental Psychopathology (EPP), the Netherlands, and the Academic Community Mental Health Centre (RIAGG, now Virenze-RIAGG Maastricht) in Maastricht, the Netherlands. Both institutes had no involvement in the collection, analysis and interpretation of the data or in the writing of this article and decision to submit this article for publication.
Keywords
- Cognitive Therapy
- Depression
- Interpersonal Psychotherapy
- Personality
- Psychotherapy