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Personality disorders are much more common among depressive patients than among normal people. Until now, little research has been conducted into the prevalence of personality disorders among patients with both major depression and dysthymia (double depression). The subject of this study is whether depressive patients with dysthymia have more personality disorders than those with no dysthymia. The Vragenlijst voor Kenmerken van de Persoonlijkheid (a Dutch self report based on the International Personality Disorder Examination) was completed for 211 outpatients with major depression. Approximately 60% of the patients suffer from one or more personality disorders. Depressive patients with dysthymia differ little from the patients without dysthymia, but patients with dysthymia have more cluster A disorders and are more avoidant. Depressive patients without dysthymia do not differ from the patients with dysthymia in terms of symptoms. Depressive patients with personality disorders have significantly more symptoms than the patients without these disorders. There is no interaction between dysthymia and personality disorder.
The prevalence of personality disorder (PD) in adults in the United States is approximately 6% (Samuels. Nestadt, Romanoski, Folstein, & McHugh, 1994) and 10% when standardized instruments are used (de Girolamo & Reich, 1993). Among depressive patients with a Major Depression (MD), prevalence is many times higher (Alnaes & Torgersen, 1991; Pilkonis & Frank, 1988; Shea, Glass, Pilkonis, Watkins, & Docherty, 1987). In these studies, 35 to 80% of the depressed patients suffered from a PD. Many depressive patients (varying from 30 to 50%) even suffered from more than one PD. The depressive patients with a PD were ill for longer and more often and were equally depressive at the start of the therapy, but they had more symptoms in terms of interpersonal sensitivity, anxiety, paranoid, and psychoticism (Shea et al., 1987). We see the same phenomenon in patients with both MD and dysthymia (a combination referred to as Double Depression [DD]). The severity of depression is greater in DD, there are fewer recoveries, and there is an increased risk of relapse (Kelley, 1994; Klein, Taylor, Handing & Dickstein, 1988). According to Levitt, Joffe, and MacDonald (1991) and Pepper, Klein, Anderson, Riso, Ouimette, and Lizards (1995), patients with DD become ill sooner and more often.
There have been few studies examining the combination of MD, DD...