Department of Psychology, University of Detroit Mercy, 241 Reno Hall, 4001 W. McNichols Road, Detroit, MI, 48221, USA.
Department of Psychiatry, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA.
Curr Psychiatry Rep. 2024 Nov;26(11):591-602. doi: 10.1007/s11920-024-01532-1. Epub 2024 Oct 3.
The relationship between depression and personality has long been a topic of interest in the fields of psychiatry and psychology, but consensus remains elusive. This lack of consensus poses a significant challenge in both diagnosis and treatment, especially in situations when otherwise effective therapies for depression fail. Our article aims to address this issue by reviewing the historical and recent conceptualizations of the relationship between depression and personality pathology. Specifically, we focus on the trait domain of negative affectivity found in the International Classification of Diseases, 11th Edition (ICD-11) and the Alternative Model for Personality Disorders (AMPD) as a connecting link between the two phenomena.
We review recent empirical studies evaluating the association of negative affectivity, personality, and depression, along with investigations of the relationship between depressive disorders and personality disorders. Additionally, we describe the Hierarchical Taxonomy of Psychopathology (HiTOP) and the AMPD as organizing frameworks for understanding depression within a broader personality framework. Based on the available evidence, we propose that depressive disorders must be assessed within the context of the patient's personality in order to maximize treatment outcomes. Ultimately, this integrated approach can guide clinicians in developing unified treatment protocols and facilitate early detection and intervention for factors contributing to depression in order to minimize treatment resistance.
抑郁与人格之间的关系一直是精神病学和心理学领域关注的焦点，但尚未达成共识。这种共识的缺乏在诊断和治疗方面都构成了重大挑战，尤其是在其他有效的抗抑郁治疗方法失败的情况下。我们的文章旨在通过回顾抑郁与人格病理学之间关系的历史和近期概念化来解决这个问题。具体来说，我们关注国际疾病分类第 11 版 (ICD-11) 和人格障碍替代模型 (AMPD) 中发现的负性情感特质领域，将这两种现象联系起来。
我们回顾了最近评估负性情感特质、人格和抑郁之间关联的实证研究，以及对抑郁障碍和人格障碍之间关系的研究。此外，我们还描述了精神病理学的分层分类法 (HiTOP) 和 AMPD，作为在更广泛的人格框架内理解抑郁的组织框架。基于现有证据，我们提出必须在患者人格的背景下评估抑郁障碍，以最大限度地提高治疗效果。最终，这种综合方法可以指导临床医生制定统一的治疗方案，并促进对导致抑郁的因素的早期检测和干预，以最小化治疗抵抗。
