In this study we aimed to examine the characteristics of patients diagnosed with depressive episode or adjustment disorder, and to explore the interplay between these diagnoses and personality disorder/traits.

Patients referred to the liaison psychiatry services at three Dublin hospitals and diagnosed with either a depressive episode or an adjustment disorder were recruited to this study. They were interviewed at time of diagnosis and again after six months using validated instruments, including SCAN (Schedule for Clinical Diagnosis in Neuropsychiatry - a semi-structured diagnostic interview schedule) and possible personality disorder as measured by SAPAS (Standardised Assessment of Personality - Abbreviated Scale).

370 patients were recruited to the study, 185 of whom had a diagnosis of an adjustment disorder; the remainder were diagnosed with a depressive episode according to ICD-10 criteria. SCAN (Schedule for Clinical Diagnosis in Neuropsychiatry - a semi-structured diagnostic interview schedule) was not useful in distinguishing between these two diagnoses. Patients with a SAPAS score above 3 (cut-off for likely personality disorder) and a diagnosis of adjustment disorder had an increased risk of suicidal behaviour (p = 0.001). When both diagnostic groups were analysed together, patients with a SAPAS score above 3 had an increased risk of suicidal behaviour (p = 0.007).

There has been little prior research into personality disorder and its association with adjustment disorder. Personality traits are associated with a diagnosis of depression rather than adjustment disorder, but have a stronger association with suicidal behaviour in patients with a diagnosis of adjustment disorder.