Influencia de los trastornos de la personalidad en el pronóstico de la depresión

Although some debate remains, the outcome in depressive disorders is almost certainly worsened by the presence of a comorbid personality disorder. This finding is intuitive but not accepted by all researchers working in the field. This may be partly due to the difficulties in designing and interpreting research studies into both disorders, to the difficulties in assessing personality pathology in cross-section when depression is present, to the variable nature of both depression and personality pathology, and to the similar aetiological factors for both disorders. Added to this, these poorer outcomes are found regardless of the type of intervention used to treat the depression. There are no studies looking at specific treatment programmes for both disorders running in parallel, making it difficult to disentangle the treatment effects of depressive disorders on the trait markers of patients. Management of patients with comorbidity requires an individually designed treatment package that takes into account the severity of each disorder and its impact on social function and psychopathology. Depression needs to be treated aggressively and specific interventions aimed at the impact of personality disorder are likely to lead to improvements. treatment length may need to be longer, as is the case for many dual disorders. Future research is needed to clarify the interrelation of both disorders. Such research is hindered by the clear differences in the current clinical classifications and time frames of both disorders when compared with the research findings to date.