TY - JOUR
T1 - Impact of Comorbid Personality Disorders on Depression Treatment in Routine Outpatient Care
AU - van Bronswijk, Suzanne C.
AU - van Dijk, Dyllis A.
AU - van den Boogaard, T. Michael
AU - Deen, Mathijs L.
AU - Ruhé, Henricus G.
AU - Spijker, Jan
AU - Peeters, Frenk P. M. L.
PY - 2022/3/3
Y1 - 2022/3/3
N2 - Objective: The impact of personality disorder on treatment effectiveness for depression has been debated, and study results have been inconsistent. However, studies that report a negative impact of personality disorders on depression treatment outcomes are often characterized by uncontrolled treatment designs. Within such contexts, individuals with depression and personality disorders are at risk to receive suboptimal treatment. The aim of this retrospective observational study was to investigate whether and to what extent comorbid personality disorders were associated with the type and amount of depression treatment received in routine outpatient care. Methods: Retrospectively extracted data from electronic records of 1,455 outpatients treated for depression at several sites of a nationwide mental health provider in the Netherlands were included. The type and number of treatment sessions and visits were analyzed by using regression models. Results: Individuals with depression and comorbid personality disorders received more psychotherapy sessions than individuals without personality disorders, irrespective of depression severity. The number of pharmacotherapy sessions and supportive and crisis visits did not differ between individuals with and without comorbid personality disorders. Conclusions: Individuals with depression and personality disorders received more intensive treatment than individuals without comorbid personality disorders. These results conflict with treatment guidelines and recommendations from high-quality studies and may be indicative of overtreatment among this large group of patients.
AB - Objective: The impact of personality disorder on treatment effectiveness for depression has been debated, and study results have been inconsistent. However, studies that report a negative impact of personality disorders on depression treatment outcomes are often characterized by uncontrolled treatment designs. Within such contexts, individuals with depression and personality disorders are at risk to receive suboptimal treatment. The aim of this retrospective observational study was to investigate whether and to what extent comorbid personality disorders were associated with the type and amount of depression treatment received in routine outpatient care. Methods: Retrospectively extracted data from electronic records of 1,455 outpatients treated for depression at several sites of a nationwide mental health provider in the Netherlands were included. The type and number of treatment sessions and visits were analyzed by using regression models. Results: Individuals with depression and comorbid personality disorders received more psychotherapy sessions than individuals without personality disorders, irrespective of depression severity. The number of pharmacotherapy sessions and supportive and crisis visits did not differ between individuals with and without comorbid personality disorders. Conclusions: Individuals with depression and personality disorders received more intensive treatment than individuals without comorbid personality disorders. These results conflict with treatment guidelines and recommendations from high-quality studies and may be indicative of overtreatment among this large group of patients.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85149036395&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/34724808
U2 - https://doi.org/10.1176/appi.psychotherapy.20210020
DO - https://doi.org/10.1176/appi.psychotherapy.20210020
M3 - Article
C2 - 34724808
SN - 0002-9564
VL - 75
SP - 150
EP - 156
JO - American journal of psychotherapy
JF - American journal of psychotherapy
IS - 1
ER -