University of Vermont.
University of Vermont.
Behav Ther. 2023 Mar;54(2):361-374. doi: 10.1016/j.beth.2022.10.002. Epub 2022 Nov 2.
Personality disorders are highly comorbid with major depression; however, findings are mixed regarding their impact on depression treatment outcomes and trajectories. Limited research has studied personality pathology in winter depression, specifically. This study (1) explored the prevalence of personality pathology in winter depression and (2) examined its effects on winter depression treatment trajectories. Participants were 174 adults with Major Depression, Recurrent with Seasonal Pattern from a randomized clinical trial comparing group cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) and light therapy. Participants completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon et al., 1994) at baseline. The prevalence of MCMI-III-defined pathological personality traits and personality disorders in this sample was 98/174 (56.3%) with any trait and 65/174 (37.4%) with any disorder. Dependent was the most common elevation (65/174, 37.4%), trait (43/174, 24.7%), and disorder (22/174, 12.6%). Most participants with pathological personality elevations had only one personality disorder (58/174, 33.3%) and one pathological personality trait (82/174, 47.1%). Growth curve analysis revealed personality pathology predicted higher baseline depression scores, but the number of MCMI-III pathological personality elevations (i.e., traits and disorders) and personality disorders did not predict change in depression over the timeframe of pretreatment, weekly during treatment, posttreatment, and follow-ups one and two winters later in CBT-SAD or light therapy. Results suggest that personality pathology is not a negative prognostic indicator or prescriptive factor for winter depression treatment with CBT-SAD or light therapy, which may inform treatment algorithms and decision-making in practice.
人格障碍与重度抑郁症高度共病；然而，关于其对抑郁症治疗结果和轨迹的影响，研究结果喜忧参半。关于冬季抑郁症中的人格病理，研究有限。本研究（1）探讨了冬季抑郁症中人格病理的患病率，（2）研究了其对冬季抑郁症治疗轨迹的影响。参与者为 174 名来自随机临床试验的有复发性季节性模式的重度抑郁症成年患者，该试验比较了季节性情感障碍的团体认知行为治疗（CBT-SAD）和光照治疗。参与者在基线时完成了明尼苏达多相人格测验第三版（MCMI-III；Millon 等人，1994 年）。在这个样本中，MCMI-III 定义的病理性人格特征和人格障碍的患病率为 98/174（56.3%）有任何特征和 65/174（37.4%）有任何障碍。依赖性是最常见的升高（65/174，37.4%），特征（43/174，24.7%）和障碍（22/174，12.6%）。大多数有病理人格升高的参与者只有一种人格障碍（58/174，33.3%）和一种病理人格特征（82/174，47.1%）。增长曲线分析表明，人格病理预测基线抑郁评分较高，但 MCMI-III 病理性人格升高（即特征和障碍）的数量和人格障碍并没有预测在 CBT-SAD 或光照治疗的治疗前、治疗期间每周、治疗后以及随后的两个冬季随访期间抑郁的变化。结果表明，人格病理不是 CBT-SAD 或光照治疗冬季抑郁症的负面预后指标或预测因素，这可能为实践中的治疗算法和决策提供信息。
