Investigations Of The Comorbidity Of The Major Depression Disorder With The Anxiety Disorder And The Personality Disorder And Research On Related Psychological Factors

Objectives1. To investigate the comorbidity of MDD and Axis I anxiety disorders2. To investigate the comorbidity of MDD and Axis II personality disorders.3. To explore childhood traumatic experiences of MDD patients including those who were also diagnosed with personality disorders and those without personality disorders. Methods1. Structured-interview: SCID-I/P was administrated to 120 MDD patients diagnosed clinically to formally determine whether they meet DSM-IV criteria for anxiety disorders .2. Scale measures: PDQ⁺⁴ (personality diagnostic questionnaire) were given to 120 MDD patients to screen their personality disorders. CTQ-SF ( childhood trauma questionnaire-Short Form) was administrated to 120 MDD patients and normal control to assess their childhood maltreated experiences.3. Semi-structured interview: Personality disorders were formally diagnosed by conducting PDI-IV (personality disorder interview-IV) to MDD patients one week after the first administration.Results1. 38.3% of the 120 MDD patients met the criteria for anxiety disorder. The most two anxiety disorder were social phobia (26.7%) and generalized anxiety disorder (20.8%).2. 58.7% of the MDD patients met the criteria for Axis II personality disorders. 39.8% of the MDD patients were diagnosed with two or more kinds of Axis II disorders. The most three disorders were AVD (38.4%), OBC (31.2%), and PAD (21.5%). Major depressive disorders existed all kinds of personality disorder.3. MDD patients scored significantly higher than normal control in CTQ-SF and all domains with the exception of physical abuse. Comparison between MDD subjects with personality disorders and control showed that the former scored significantly higher in emotional abuse, sex abuse, physical neglect, and emotional neglect domains. Whereas MDD subjects without personality disorders only scored significantly higher in emotional neglect domains compared with control. Conclusions1. Comorbidity of MDD(major depression disorder) and anxiety disorders occurs pervasively.2. MDD patients are often diagnosed with Axis II personality disorders, especially with Cluster-C. "Pure MDD" is a clinically infrequent subtype.3. Subjects with personality disorders experienced more severe traumatic events during their early life, indicating that several forms of childhood maltreatment serve as risk factors for the development of comorbidity of MDD and personality disorders. Emotional neglect, however, might be the most risk factor for the development of "pure MDD".