Occurrence and Effects of Personality Disorders in Depression: Are They the Same in the Old and Young?

Abstract

Objectives: To determine the frequency and effects of personality disorders on episodes of depression in elderly and young inpatients. Personality disorders are common and may affect the prognosis of Axis I disorders. Methods: Clinical records of 89 elderly inpatients and a matched comparison group of 119 young inpatients were reviewed to confirm the diagnosis of a major depressive episode according to the DSM-III-R criteria. The frequency of personality disorder diagnoses in the 2 groups was determined. Within each group, severity, functioning, and treatment were compared between those with and without personality disorders. Results: Personality disorders were diagnosed more frequently in the young (40.3%) than in the elderly (27%). Both rates were similar to previous reports. Cluster C disorders were the most common personality disorders found in the elderly, compared to cluster B disorders in the young. Personality disorder in the young was associated with longer episodes of depression (P = 0.035) and poorer family relations (P < 0.001); whereas in the elderly, personality disorder was associated with more severe episodes (P = 0.014). Conclusions: These findings suggest that the frequency and effects of personality disorders on the depressed patient may differ according to age.