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The impact of personality dysfunction on the outcome of treatment for
depression remains debated.
To examine the relationship between the number of prior depressive
episodes, personality dysfunction and treatment response for
In a large sample (n = 8229) of adult out-patients with
a major depressive episode (DSM–IV), personality dysfunction was assessed
using the Standardised Assessment of Personality – Abbreviated Scale
(SAPAS). Potential predictors of treatment response at 6 weeks were
examined via structural equation modelling.
The amount of personality dysfunction and number of prior episodes of
depression were both associated with poor response to treatment. Once
personality dysfunction was controlled for, the number of prior episodes
of depression was not associated with treatment response.
Personality dysfunction is associated with impaired short-term response
to antidepressant treatment in major depression. The apparent detrimental
effect of prior depression on treatment response may be accounted for by
pre-existing personality dysfunction.