TY - JOUR
T1 - Borderline personality disorder in major depression
T2 - Symptomatology, temperament, character, differential drug response, and 6-month outcome
AU - Joyce, Peter R.
AU - Mulder, Roger T.
AU - Luty, Suzanne E.
AU - McKenzie, Janice M.
AU - Sullivan, Patrick F.
AU - Cloninger, Robert C.
N1 - Funding Information:
From the Department of Psychological Medicine, Christchurch School of Medicine, Christchurch, New Zealand; Department of Psychiatry, Virginia Commonwealth University, Richmond, VA; and the Department of Psychiatry, Washington University at St. Louis, St. Louis, MO. Supported in part by a grant from the Health Research Council of New Zealand, and by an unrestricted grant from Eli Lilly (New Zealand) Ltd. Address reprint requests to Professor Peter R. Joyce, Department of Psychological Medicine, Christchurch School of Medicine, PO Box 4345, Christchurch, New Zealand. Copyright 2003, Elsevier Science (USA). All rights reserved. 0010-440X/03/4401-0020$35.00/0 doi:10.1053/comp.2003.50001
PY - 2003
Y1 - 2003
N2 - Among 183 depressed patients participating in a randomized long-term treatment trial of fluoxetine and nortriptyline, 30 patients had borderline personality disorder (BPD), 53 had other personality disorders (OPD), and 100 had no personality disorders (NPD). The borderline depressed patients had earlier age of onset of their depressions, more chronic depressions, more alcohol and cannabis comorbidity, and were more likely to have histories of suicide attempts and of self-mutilation. On self-report, patients with BPD and OPD reported more phobic symptoms, greater interpersonal sensitivity, and more paranoid ideation. Uniquely, BPD patients were more angry than OPD patients. BPD patients had high novelty seeking, high harm avoidance, low self-directedness, and low cooperativeness. Depressed patients with BPD did poorly in the short term if treated with nortriptyline rather than fluoxetine. After 6 months, those with BPD had a favorable outcome in regard to depressive symptoms, social adjustment, and even improvement in the character measure of self-directedness. Those with the poorest outcome were those with OPD.
AB - Among 183 depressed patients participating in a randomized long-term treatment trial of fluoxetine and nortriptyline, 30 patients had borderline personality disorder (BPD), 53 had other personality disorders (OPD), and 100 had no personality disorders (NPD). The borderline depressed patients had earlier age of onset of their depressions, more chronic depressions, more alcohol and cannabis comorbidity, and were more likely to have histories of suicide attempts and of self-mutilation. On self-report, patients with BPD and OPD reported more phobic symptoms, greater interpersonal sensitivity, and more paranoid ideation. Uniquely, BPD patients were more angry than OPD patients. BPD patients had high novelty seeking, high harm avoidance, low self-directedness, and low cooperativeness. Depressed patients with BPD did poorly in the short term if treated with nortriptyline rather than fluoxetine. After 6 months, those with BPD had a favorable outcome in regard to depressive symptoms, social adjustment, and even improvement in the character measure of self-directedness. Those with the poorest outcome were those with OPD.
UR - http://www.scopus.com/inward/record.url?scp=0037219822&partnerID=8YFLogxK
U2 - 10.1053/comp.2003.50001
DO - 10.1053/comp.2003.50001
M3 - Article
C2 - 12524634
AN - SCOPUS:0037219822
VL - 44
SP - 35
EP - 43
JO - Comprehensive Psychiatry
JF - Comprehensive Psychiatry
SN - 0010-440X
IS - 1
ER -