DSM-III-R Personality Disorders Among Patients With Depressive And/Or Anxiety Disorders

Abstract

A sample of 223 psychiatric outpatients with diagnoses according to DSM-III-R criteria of depressive (major depression or dysthymia) and/or anxiety disorders was divided into three subsamples: depressive disorders (N = 100), depressive disorders in combination with anxiety disorders (N = 49), and pure anxiety disorders (N = 74). The combined anxiety-depressive (CAD) group manifested a statistically significantly higher frequency of “any” personality disorder, paranoid personality disorder (PD), and borderline PD, and also had significantly higher scores on the majority of the clinical scales and on some of the research scales of the MMPI, compared to the two other groups. The presence of an additional diagnosis of a personality disorder was related to significantly higher scores on almost all the MMPI clinical and research scales and that was the case for the total sample and for the three subsamples, as well. The findings of the present study imply that: (1) A concomitant diagnosis of a personality disorder (Axis II) in patients with depressive and/or anxiety disorders (Axis I) is related to more severe psychopathology, as measured by the MMPI. This underscores the importance of personality assessment in the evaluation of the above syndromes in clinical practice. (2) The CAD group appeared to be the more deviant, with a higher rate and more severe personality disorders, and also with greater psychopathological loading, as measured by the MMPI. Therefore it is important these cases be distinguished in both clinical and research practice, and that special attention be paid to the interaction between anxiety, depression, and personality disorder.