J Pers Disord. 2014 Aug;28(4):577-93. doi: 10.1521/pedi_2013_27_070. Epub 2013 Nov 20.
There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with depressive disorders and whether this is influenced by type of treatment, a systematic electronic search of MEDLINE, CINAHL, and PsycINFO from 1966, 1982, and 1882, respectively, until February 2007 was undertaken. The keyword terms depression, mental illness, and personality disorder were used. All references were reviewed and personal correspondence was undertaken. Only English language papers were considered. Any English language paper studying a depressed adult population was considered for inclusion. Studies needed to clearly define depression and personality disorder using peer-reviewed instruments or International Classification of Disease/Diagnostic Statistical Manual criteria. Outcome assessment at greater than 3 weeks was necessary. Final inclusion papers were agreed on by consensus by at least two reviewers. All data were extracted using predetermined criteria for depression by at least two reviewers in parallel. Disagreement was settled by consensus. Complex data extraction was confirmed within the study group. Data were synthesized using log odds ratios in the Cochrane RevMan 5 program. The finding of comorbid personality disorder and depression was associated with a more than double the odds of a poor outcome for depression compared with those with no personality disorder (OR 2.16, CI 1.83-2.56). This effect was not ameliorated by the treatment modality used for the depressive disorder. This finding led to the conclusion that personality disorder has a negative impact on the outcome of depression. This finding is important in considering prognosis in depressive disorders.
关于人格障碍对抑郁障碍结局的影响以及与治疗的相对相互作用，一直存在争议。为了确定人格障碍，无论是一般意义上的还是个体聚类意义上的，是否会导致抑郁障碍患者的结局更差，以及这种情况是否受到治疗类型的影响，我们分别对 1966 年、1982 年和 1882 年的 MEDLINE、CINAHL 和 PsycINFO 进行了系统的电子检索，直到 2007 年 2 月。使用了关键词“抑郁”、“精神疾病”和“人格障碍”。对所有参考文献进行了回顾，并进行了个人通信。只考虑英语文献。任何研究抑郁成年人群的英语文献都被认为是可以纳入的。研究需要使用经过同行评审的工具或国际疾病分类/诊断统计手册标准明确定义抑郁和人格障碍。需要在 3 周以上进行结果评估。最终纳入的论文由至少两名评审员一致同意。所有数据均由至少两名评审员使用预定的标准，根据抑郁情况平行提取。通过共识解决分歧。在研究小组内确认了复杂的数据提取。使用 Cochrane RevMan 5 程序中的对数优势比对数据进行综合分析。共病人格障碍和抑郁的发现与无人格障碍的患者相比，抑郁结局较差的几率增加了一倍多（OR 2.16，CI 1.83-2.56）。这种效果不会因抑郁障碍所使用的治疗方式而改善。这一发现得出的结论是，人格障碍对抑郁的结局有负面影响。这一发现对于考虑抑郁障碍的预后很重要。
