Personality disorder comorbidity with major depression and response to
treatment with sertraline or citalopram
by
Ekselius L, von Knorring L
Department of Neuroscience,
Psychiatry, University Hospital, Uppsala, Sweden.
Int Clin Psychopharmacol 1998 Sep; 13(5):205-11
ABSTRACT
The purpose of this study was to investigate the frequency of DSM-III-R
personality disorders in depressed patients treated in primary care, and to
examine the effect of sertraline or citalopram on the diagnosis of personality
disorders. A total of 308 patients with a major depressive disorder were
assessed with the Swedish version of the Structured Clinical Interview for
Personality Disorders (SCID) screen questionnaire, before and after 24 weeks
double-blind treatment with sertraline (50-150 mg/day) or citalopram (20-60
mg/day). Following treatment, significant reductions in the frequency of
paranoid, borderline, avoidant and dependent personality disorder diagnoses were
seen in both treatment groups. When the personality disorders were analysed as
continuous, dimensional personality traits significant reductions were seen for
most personality categories. To elucidate if the observed reductions in
personality disorder criteria could be explained by the improvement in
depressive symptomatology, a series of multiple regressions were made. Reduction
of depression scores was of some importance for the changes in most personality
disorders. However, the multiple R never exceeded 0.24 (cluster C). Type of drug
was of importance only as concerns obsessive-compulsive personality disorder.
Overall, the results suggest that sertraline and citalopram may be beneficial in
the treatment of certain personality disorder traits in patients with major
depressive disorders.
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