Efficacy of pharmacotherapy in depressed patients with and without personality disorders: a systematic review and meta-analysis.

Abstract

BACKGROUND:

During the past decades personality pathology was considered to have a negative influence on the outcome of pharmacotherapy of depressive disorders. Recently, there has been a shift towards a less negative opinion. Still, the evidence in the literature remains inconclusive. This may be explained by methodological differences between published studies.

OBJECTIVE:

To present a meta-analysis of the results of Randomised Controlled Trials with pharmacotherapy in the treatment of depression with comorbid personality disorders.

METHOD:

Systematic literature search for RCTs in adult ambulatory patients with major depressive disorder and comorbid PDs; pooling of data and meta-analysis according to strict methodological criteria.

RESULTS:

The difference in remission rates between the groups with and without personality disorders in high quality studies was 3%; this difference was neither statistically significant nor clinically relevant.

LIMITATIONS:

Due to the specific and sensitive methods of the search only six studies could be included in the meta-analysis. Due to lack of data, analyses of drop-out rates could not be made.

CONCLUSION:

When only data from high quality RCTs are included, comorbidity of personality disorder and major depression does not have a negative effect on the treatment outcome of pharmacotherapy for major depression.

• Authors: Simone Kool, Robert Schoevers, Saskia de Maat, Rien Van, Pieter Molenaar, Aukje Vink, Jack Dekker
• Journal: Journal of affective disorders (J Affect Disord) Vol. 88 Issue 3 Pg. 269-78 (Nov 2005) ISSN: 0165-0327 [Print] Netherlands
• PMID: 16165217 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Topics

• Comorbidity
• Depressive Disorder (complications, drug therapy, psychology)
• Humans
• Outpatients
• Personality Disorders (complications, psychology)
• Prognosis
• Randomized Controlled Trials as Topic
• Treatment Outcome