Max Planck Institute of Psychiatry, Munich, Germany.
Department of Psychology, University of Kassel, Kassel, Germany.
Psychol Med. 2023 Jul;53(10):4405-4414. doi: 10.1017/S0033291722001209. Epub 2022 May 10.
Advancements in the treatment of depression are pivotal due to high levels of non-response and relapse. This study evaluated the role of personality pathology in the treatment of depression by testing whether maladaptive personality traits (1) predict changes in depression over treatment or , (2) change themselves over treatment, (3) change differentially depending on treatment with schema therapy (ST) or cognitive behavioural therapy (CBT), and (4) moderate the effectiveness of these treatments.
We included 193 depressed inpatients (53.4% women, = 42.9, SD = 13.4) participating in an assessor-blind randomized clinical trial and receiving a 7-week course of ST or CBT. The research questions were addressed using multiple indicator latent change score models as well as multigroup structural equation models implemented in EffectLiteR.
Maladaptive traits did not predict changes in depressive symptoms at post-treatment, or . However, maladaptive trait domains decreased over treatment (standardized Δ range: -0.38 to -0.89), irrespective of treatment with ST or CBT. Maladaptive traits at baseline did not moderate the effectiveness of these treatments.
Self-reported maladaptive personality traits can change during treatment of depression, but may have limited prognostic or prescriptive value, at least in the context of ST or CBT. These results need to be replicated using follow-up data, larger and more diverse samples, and informant-rated measures of personality pathology.
由于治疗反应率低和复发率高，抑郁症治疗方面的进展至关重要。本研究通过检验适应不良人格特质是否（1）预测治疗过程中抑郁的变化，或（2）在治疗过程中发生变化，（3）是否因接受图式治疗（ST）或认知行为治疗（CBT）而发生不同变化，以及（4）调节这些治疗的效果，评估人格病理学在抑郁症治疗中的作用。
我们纳入了 193 名住院抑郁症患者（53.4%为女性， = 42.9，SD = 13.4），他们参加了一项评估者盲法随机临床试验，并接受了为期 7 周的 ST 或 CBT。使用多指标潜在变化分数模型以及在 EffectLiteR 中实现的多组结构方程模型来解决研究问题。
适应不良特质既不能预测治疗后抑郁症状的变化，也不能预测治疗中的变化。然而，无论接受 ST 还是 CBT 治疗，适应不良特质领域在治疗过程中均呈下降趋势（标准化Δ范围：-0.38 至-0.89）。治疗前的适应不良特质并不能调节这些治疗的效果。
自我报告的适应不良人格特质在抑郁症治疗过程中可能会发生变化，但至少在 ST 或 CBT 的背景下，其预后或预测价值可能有限。这些结果需要使用随访数据、更大和更多样化的样本以及人格病理学的知情评定量表进行复制。
