Frequency and Implications of Personality Disorders in a Sample of Depressed Outpatients

The frequency of DSM-III, Axis II personality disorders and their relationship to selected demographic and clinical characteristics were investigated in a sample of 249 outpatients with major depressive disorder. Thirty-five percent of the sample had at least one personality disorder using stringent criteria; an additional 40% had a probable personality disorder. The most frequent disorders were in the “anxious' cluster of Axis II, including avoidant, dependent, and obsessive-compulsive. Paranoid, histrionic, and borderline were the next most common disorders. Personality disorder patients had more prior episodes of depression and were more likely to be diagnosed as recurrent MDD. They also had a longer duration of current episode, were more likely to have a diagnosis of endogenous depression, and had higher ratings of distress on multiple dimensions of general symptomatology. In addition, patients in the Axis II “odd” and “dramatic” clusters were less likely to be married, and dramatic patients were younger at age of first episode and had a history of more suicide attempts.