Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-31T15:31:21.667Z Has data issue: false hasContentIssue false
  • English
  • Français

The role of personality disorder in ‘difficult to reach’ patients with depression: Findings from the ODIN study

Published online by Cambridge University Press:  16 April 2020

Brendan D. Kelly ,
Patricia Casey ,
Graham Dunn ,
Jose Luis Ayuso-Mateos  and
Christopher Dowrick
Brendan D. Kelly*
Affiliation:
Department of Adult, Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland
Patricia Casey
Affiliation:
Department of Adult, Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland
Graham Dunn
Affiliation:
Biostatistics Group, Division of Epidemiology and Health Sciences, University of Manchester, Manchester, UK
Jose Luis Ayuso-Mateos
Affiliation:
Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autónoma de Madrid, Madrid, Spain
Christopher Dowrick
Affiliation:
Division of Primary Care, University of Liverpool, Liverpool, UK
*
*Corresponding author. Tel.: +353 1 803 4474; fax: +353 1 830 9323. E-mail address:[email protected] (B.D. Kelly).
Get access

Abstract

Individuals with personality disorders (especially paranoid personality disorder) tend to be reluctant to engage in treatment. This paper aimed to elucidate the role of personality disorder in predicting engagement with psychological treatment for depression. The Outcomes of Depression International Network (ODIN) involves six urban and three rural study sites throughout Europe at which cases of depression were identified through a two-stage community survey. One patient in seven who was offered psychological treatment for depression had a comorbid diagnosis of personality disorder (most commonly paranoid personality disorder). Forty-five percent of patients who were offered psychological treatment for depression did not complete treatment. The odds of completion were higher for patients with a comorbid diagnosis of personality disorder, especially paranoid, anxious or dependent personality disorder. The relatively low number of cases with some specific personality disorders (e.g. schizoid personality disorder) limited the study's power to reach conclusions about these specific disorders. This study focused on a community-based sample which may lead to apparently lower rates of engagement when compared to studies based on treatment-seeking populations. Episodes of depression in the context of personality disorder may represent a valuable opportunity to engage with patients who might otherwise resist engagement.

Keywords

Personality disorderDepressionTreatment
Type
Epidemiology and Social Psychiatry
Information
European Psychiatry , Volume 22 , Issue 3 , April 2007 , pp. 153 - 159
Copyright
Copyright © Elsevier Masson SAS 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.Washington, DC: American Psychiatric Press; 1994.Google Scholar
Ayuso-Mateos, J.L.Vázquez-Barquero, J.-L.Dowrick, C.Lehtinen, V.Dalgard, O.S.Casey, P.et al.Depressive disorders in Europe: prevalence figures from the ODIN study. Br J Psychiatry 2001;179:308–316.10.1192/bjp.179.4.308CrossRefGoogle ScholarPubMed
Beck, A.Ward, C.Mendelson, M.Mock, J.Erbaugh, J.An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–571.10.1001/archpsyc.1961.01710120031004CrossRefGoogle ScholarPubMed
Casey, P.Birbeck, G.McDonagh, C.Horgan, A.Dowrick, C.Dalgard, O.et al.Personality disorder, depression and functioning: results from the ODIN study. J Affect Disord 2004;82:277–283.10.1016/j.jad.2003.11.009CrossRefGoogle ScholarPubMed
Centorrino, F.Hernan, M.A.Drago-Ferrante, G.Rendall, M.Apicella, A.Langar, G.et al.Factors associated with non-compliance with psychiatric outpatient visits. Psychiatr Serv 2001;52:378–380.10.1176/appi.ps.52.3.378CrossRefGoogle Scholar
Coid, J.Yang, M.Tyrer, P.Roberts, A.Ullrich, S.Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 2006;188:423–431.10.1192/bjp.188.5.423CrossRefGoogle ScholarPubMed
Dowrick, C.Casey, P.Dalgard, O.Hosman, C.Lehtinen, V.Vázquez-Barquero, J.-L.et al.Outcome of Depression International Network (ODIN). Br J Psychiatry 1998;172:359–363.10.1192/bjp.172.4.359CrossRefGoogle Scholar
Dowrick, C.Dunn, G.Ayuso-Mateos, J.L.Dalgard, O.S.Page, H.Lehtinen, V.et al.Problem solving treatment and group psychoeducation for depression: multicentre randomized controlled trial. Br Med J 2000;321:1–6.10.1136/bmj.321.7274.1450CrossRefGoogle Scholar
Goldberg, D.Huxley, P.Common mental disorders: a biosocial model. London: Routledge; 1992.Google Scholar
Heppner, P.P.Peterson, C.H.The development and implications of a personal problem solving inventory. J Counsel Psychol 1982;29:66–75.10.1037/0022-0167.29.1.66CrossRefGoogle Scholar
Maddox, J.C.Levi, M.Thompson, C.The compliance with antidepressants in general practice. J Psychopharmacol 1994;8:48–53.10.1177/026988119400800108CrossRefGoogle ScholarPubMed
Matas, M.Staley, D.Griffin, W.A profile of the non-compliant patient: a thirty-month review of outpatient psychiatry referrals. Gen Hosp Psychiatry 1992;14:124–130.10.1016/0163-8343(92)90037-BCrossRefGoogle Scholar
Nemeroff, C.B.Improving antidepressant adherence. J Clin Psychiatry 2003;64(Suppl. 18):25–30.Google ScholarPubMed
Paykel, E.S.Priest, R.G.Recognition and management of depression in general practice: consensus statement. Br Med J 1992;161:663–667.Google Scholar
Shanks, J.Kheraj, S.Fish, S.Better ways of assessing health needs in primary care. Br Med J 1995;310:480–481.10.1136/bmj.310.6978.480CrossRefGoogle ScholarPubMed
SPSS Inc. SPSS User Guide Base Statistics 6.1. Chicago: SPSS Inc.; 1994.Google Scholar
Stewart, A.Hays, R.Ware, J.The MOS short-form general health survey: reliability and validity in the patient population. Med Care 1998;26:724–732.10.1097/00005650-198807000-00007CrossRefGoogle Scholar
Tyrer, P.Alexander, J.Classification of personality disorder. Br J Psychiatry 1979;135:163–167.10.1192/bjp.135.2.163CrossRefGoogle ScholarPubMed
Tyrer, P.Mitchard, S.Methuen, C.Ranger, M.Treatment rejecting and treatment seeking personality disorders: Type R and Type S. J Personal Disord 2003;17:263–268.10.1521/pedi.17.3.263.22152CrossRefGoogle ScholarPubMed
World Health Organization. Schedule for clinical assessment in neuropsychiatry: version 2.0. Geneva: World Health Organization (Division of Mental Health); 1994.Google Scholar
World Health Organization. The ICD-10 classification of mental and behavioural disorders. Geneva: World Health Organization; 1994.Google Scholar
World Health Organization. The World Health Report 2001: Mental health: new understanding new hope. Geneva: World Health Organization; 2001.Google Scholar
Submit a response

Comments

No Comments have been published for this article.