Personality disorders and social functioning in depressed patients

There is a high level of comorbidity of personality disorders with major depression. Patients who suffer from both depression and an axis II disorder are, in general, more severely ill and ill for longer periods. The presence of personality disorders also has a negative influence on the social functioning of depressed patients, and it has emerged that certain demographic characteristics are present to a significant extent. This article presents the results of a study of 244 out-patients suffering from major depression. The issues addressed were: Firstly, which axis II disorders are found in this group and are there correlations with the demographic characteristics? Secondly is there a relationship between individual axis II disorders and the severity of the depression and social functioning? It emerges that 60% of the patients with a Hamilton score of at least 14 have one or more axis II disorders according to the VKP self-report, and that 30 % have three or more, with more than 50% in cluster C. It was found also that the schizoid and borderline personality disorders in particular are significantly linked to several demographic characteristics. The patients here an more often single and those with a lower level of education. Using the Hamilton Depression Rating Scale, little significant correlation was found between the presence of an axis II disorder and the severity of the depression. A significant difference was found using the Symptom Check List -90. In social functioning the citizen role, the social role and the family role turn out to be correlated most significantly, as are the total number of impairments. In addition, the highest correlation is found particularly in cluster C, and the number of axis II disorders is almost always significantly related to the individual roles. The discussion turns to the influence of the measuring instruments used and to the composition of the population, as well as the clinical relevance of the diagnosis of axis II disorders and social functioning in patients with a major depression.