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Bedeutung prämorbider Persönlichkeitsstrukturen für die Entwicklung therapieresistenter Depressionen

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Akute und therapieresistente Depressionen

Zusammenfassung

Bestimmte prämorbide Persönlichkeitsmerkmale wie Neurotizismus und Rigidität sind wahrscheinlich als Risikofaktoren anzusehen, die die individuelle Vulnerabilität für depressive Störungen erhöhen und den weiteren, insbesondere den langfristigen Therapieverlauf ungünstig beeinflussen. Bezüglich der Persönlichkeitsdimensionen »harm avoidance«, »novelty seeking« und »reward dependence« ist die empirische Basis gegenwärtig zu schmal, um diesen Temperamentsformen verlaufsprädiktive Bedeutung zuzumessen. Persönlichkeitsstörungen scheinen nach jüngsten Studien und entgegen früherer Auffassung Verlauf und Ausgang von depressiven Störungen nicht negativ zu beeinflussen. Die Responseprädiktivität abweichender Persönlichkeitseigenschaften ist, wie jüngere Studien mit klassischen und modernen Antidepressiva sowie verschiedenen Psychotherapien zeigten, u. U. abhängig von der ausgewählten Behandlung. Positive Prädiktoren eines Ansprechens auf eine Behandlung scheinen hohe Autonomie, niedrige Soziotropie, Selbstsicherheit, Unabhängigkeit und Konkurrenzfähigkeit zu sein. Neben einer sorgfältigen Diagnose der depressiven Symptomatik sollte daher immer geprüft werden, ob auffällige Persönlichkeitszüge oder Persönlichkeitsstörungen das klinische Bild zusätzlich begleiten, um das Behandlungskonzept auf den individuellen Patienten mit seinem spezifischen Störungsbild abzustimmen.

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Literatur

  • Akiskal HS, Hirschfeld MA, Yerevanian BI (1983) The relationship of personality to affective disorders — a critical review. Arch Gen Psychiatry 40: 801–10

    PubMed  Google Scholar 

  • Alnaes R, Torgersen S (1997) Personality and personality disorders predict development and relapses of major depression. Acta Psychiatr Scand 95: 336–342

    PubMed  Google Scholar 

  • Andreoli A, Frances A, Gex-Fabry M, Aapro N, Gerin P, Dazord A (1993) Crisis intervention in depressed patients with and without DSM-III-R personality disorders. J Nerv Ment Dis 181: 732–737

    PubMed  Google Scholar 

  • Angst J (1988) Risikofaktoren für den Verlauf affektiver Störungen. In: Zerssen D von, Möller HJ (Hrsg) Affektive Störungen. Diagnostische, epidemiologische, biologische und therapeutische Aspekte. Springer, Berlin Heidelberg New York Tokio, pp 99–110

    Google Scholar 

  • Angst J, Clayton PJC (1986) Premorbid personality of depressive, bipolar and schizophrenic patients with special reference to suicidal issues. Comp Psychiatry 27: 511–532

    Article  Google Scholar 

  • Berlanga C, Heinze G, Torres M, Apiquian R, Caballero A (1999) Personality and clinical predictors of recurrence of depression. Psychiatr Serv 50: 376–380

    PubMed  Google Scholar 

  • Bielski R, Friedel RO (1976) Prediction of tricyclic antidepressant response. A critical review. Arch Gen Psychiatry 33: 1479–1489

    PubMed  Google Scholar 

  • Black DW, Bell S, Hulbert J, Nasrallah A (1988) The importance of axis II in patients with major depression. J Affect Disord 14: 115–122

    Article  PubMed  Google Scholar 

  • Carney MWP, Roth M, Garside RF (1965) The diagnosis of depressive syndroms and the prediction of ECT response. Br J Psychiatry 111: 659–674

    PubMed  Google Scholar 

  • Carrol BJ, Greden JF, Feinberg M, Kronfol Z, Gardner R, Albala AA (1982) Neuroendocrine evaluation of depression in borderline patients. Psychiatr Clin North Am 4: 89–99

    Google Scholar 

  • Charney DS, Nelson CJ, Quinlan DM (1981) Personality traits and disorder in depression. Am J Psychiatry 138: 1601–1604

    PubMed  Google Scholar 

  • Cloninger CR (1987) A systematic method for clinical description of personality variants. Arch Gen Psychiatry 44: 573–588

    PubMed  Google Scholar 

  • Corruble E, Ginestet D, Guelfi JD (1996) Comorbidity of personality disorders and unipolar major depression: a review. J Affect Disord 37: 157–170

    Article  PubMed  Google Scholar 

  • Dally PJ, Connolly J (1981) An introduction to physical methods of treatment in psychiatry, 6th edn. Churchill Livingstone, New York

    Google Scholar 

  • Davidson J, Miller R, Strickland R (1985) Neuroticism and personality disorder in depression. J Affect Disord 8: 177–182

    PubMed  Google Scholar 

  • Diguer L, Barber JP, Luborsky L (1993) Three concomitants: personality disorders, psychiatric severity, and outcome of dynamic psychotherapy of major depression. Am J Psychiatry 150: 1246–1248

    PubMed  Google Scholar 

  • Downs N, Swerdlow N, Zisook S (1992) The relationship of affective illness and personality disorders in psychiatric outpatients. Ann Clin Psychiatry 4: 87–94

    Google Scholar 

  • Duggan C, Lee A, Murray R (1990) Does personality predict long-term outcome in depression? Br J Psychiatry 157: 19–24

    PubMed  Google Scholar 

  • Elkin I, Parloff MB, Hadley SW, Antry JH (1985) The National Institute of Mental Health Treatment of Depression Collaborative Research Program: Background and research plan. Arch Gen Psychiatry 42: 305–316

    PubMed  Google Scholar 

  • Ezquiaga E, Garcia A, Bravo F, Pallares T (1998) Factors associated with outcome in major depression: a 6-month prospective study. Soc Psychiatry Psychiatr Epidemiol 33: 552–557

    Article  PubMed  Google Scholar 

  • Faravelli C, Ambonetti A, Pallanti S, Pazzagli A (1986) Depressive relapses and incomplete recovery from index episode. Am J Psychiatry 143: 888–891

    PubMed  Google Scholar 

  • Fava M, Bouffides E, Pava JA, McCarthy MK, Steingard RJ, Rosenbaum JF (1994) Personality disorder comorbidity with major depression and response to fluoxetine treatment. Psychother Psychosom 62: 160–167

    PubMed  Google Scholar 

  • Frank E, Kupfer DJ, Jacob M, Jarrett D (1987) Personality features and response to acute treatment in recurrent depression. J Pers Disord 1: 14–26

    Google Scholar 

  • Gormley N, O'Leary D, Costello F (1999) First admissions for depression: is the »no-treatment interval« a critical predictor of time to remission? J Affect Disord 54: 49–54

    Article  PubMed  Google Scholar 

  • Greenberg MD, Craighead WE, Evans DD, Craighead LW (1995) An investigation of the effects of comorbid axis II pathology on outcome of inpatient treatment for unipolar depression. J Psychopathol Behav Assess 17: 305–321

    Google Scholar 

  • Hardy GE, Barkham M, Shapiro DA, Stiles WB, Rees A, Reynolds S (1995) Impact of cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression. J Consult Clin Psychol 63: 997–1004

    Article  PubMed  Google Scholar 

  • Helmchen H (1974) Symptomatology of therapy-resistent depressions. Pharmacopsychiatry 7: 145–155

    Google Scholar 

  • Henderson S, Byrne DG, Duncan-Jones P (1981) Neurosis and the social environment. Academic Press, New York

    Google Scholar 

  • Hirschfeld MA, Klerman GL, Andreasen NC, Clayton PJ, Keller MB (1986) Psychosocial predictors of chronicity in depressed patients. Br J Psychiatry 148: 648–654

    PubMed  Google Scholar 

  • Hirschfeld MA, Klerman GL, Lavori P, Keller MB, Griffith P, Coryell W (1989) Premorbid personality assessment of first onsets of major depression. Arch Gen Psychiatry 46: 345–350

    PubMed  Google Scholar 

  • Hirschfeld RM, Russell JM, Delgado PL et al. (1998) Predictors of response to acute treatment of chronic and double depression with sertraline or imipramine. J Clin Psychiatry 59: 669–775

    PubMed  Google Scholar 

  • Hoffart A, Martinsen EW (1993) The effect of personality disorders and anxious-depressive comorbidity on outcome in patients with unipolar depression and with panic disorder and agoraphobia. J Personal Disord 7: 304–311

    Google Scholar 

  • Ilardi S, Craighead WE, Evans DD (1995) Personality pathology and response to somatic treatments for major depression: a critical review. Depression 2: 200–217

    Google Scholar 

  • Ilardi S, Craighead WE, Evans DD (1997) Modeling relapse in unipolar depression: the effects of dysfunctional cognitions an personality disorders. J Consult Clin Psychol 65: 381–391

    Article  PubMed  Google Scholar 

  • Joffe RT, Regan JJ (1989) Personality and response to tricyclic antidepressants in depressed patients. J Nerv Ment Dis 177: 745–749

    PubMed  Google Scholar 

  • Joffe RT, Bagby RM, Levitt AJ, Regan JJ, Parker JD (1993) The Tridimensional Personality Questionnaire in major depression. Am J Psychiatry 150: 959–960

    PubMed  Google Scholar 

  • Joyce PR, Paykel ES (1989) Predictors of drug response in depression. Arch Gen Psychiatry 46: 89–99

    PubMed  Google Scholar 

  • Joyce PR, Mulder RT, Cloninger CR (1994) Temperament predicts clomipramine and desipramine response in major depression. J Affect Disord 30: 35–46

    Article  PubMed  Google Scholar 

  • Kay DW, Garside RF, Roy JR, Beamish P (1969) »Endogenous« and »neurotic« syndromes of depression: a 5 to 7 year follow-up of 104 cases. Br J Psychiatry 115: 389–399

    PubMed  Google Scholar 

  • Kay DW, Garside RF, Fahy TJ (1973) A double-blind trial oft phenelzine and amitriptyline in depressed out-patients: a possible differential effect of the drugs on symptoms. Br J Psychiatry 123: 63–67

    PubMed  Google Scholar 

  • Kerr TA, Roth M, Schapira K, Gurney C (1972) The assessment and prediction of outcome in affective disorders. Br J Psychiatry 121: 167–174

    PubMed  Google Scholar 

  • Kronmüller KT, Backenstraß M, Reck C, Kraus A, Fiedler P, Mundt C (2002) Einfluß von Persönlichkeitsfaktoren und-struktur auf den Verlauf der Major-Depression. Nervenarzt 73: 255–261

    PubMed  Google Scholar 

  • Kupfer DJ, Spiker DG (1981) Refractory depression. Prediction of non-response by clinical indicators. J Clin Psychiatry 42: 307–312

    PubMed  Google Scholar 

  • MacEwan GW, Remick RA (1988) Treatment resistant depression: a clinical perspective. Can J Psychiatry 33: 788–792

    PubMed  Google Scholar 

  • Maier W, Minges J, Lichtermann D, Hallmayer J, Fischer O (1992) Persönlichkeitsfaktoren als Risiko-und Krankheitsindikatoren der unipolaren Depression. In: Marneros A, Philipp M (Hrsg) Persönlichkeit und psychische Erkrankung. Springer, Berlin Heidelberg New York Tokio

    Google Scholar 

  • Maneros A, Deister A, Rohde A (1991) Affektive, schizoaffektive und schizophrene Psychosen. Springer, Berlin Heidelberg New York Tokio

    Google Scholar 

  • McGlashan TM (1987) Borderline personality disorder and unipolar affective disorder. Long-term effects of comorbidity. J Nerv Ment Dis 175: 467–473

    PubMed  Google Scholar 

  • Mulder RT (2002) Personality pathology and treatment outcome in major depression: a review. Am J Psychiatry 159: 359–371

    Article  PubMed  Google Scholar 

  • Mulder RT, Joyce PR, Luty SE (2003) The relationship of personality disorders to treatment outcome in depressed outpatients. J Clin Psychiatry 64: 259–264

    PubMed  Google Scholar 

  • Nelsen MR, Dunner DL (1995) Clinical and differential diagnostic aspects of treatment-resistant depression. J Psychiatr Res 29: 43–50

    PubMed  Google Scholar 

  • Nelson EC, Cloninger CR (1995) The tridimensional personality questionnaire as a predictor of response to nefadozone treatment of depression. J Affect Disord 35: 51–57 (correction 1997, 44: 201)

    Article  PubMed  Google Scholar 

  • Newman JR, Ewing SE, McColl RD, Borus JS, Nierenberg AA, Pava J, Fava M (2000) Tridimensional Personality Questionnaire and treatment response in major depressive disorder: a negative study. J Affect Disord 57: 241–247

    Article  PubMed  Google Scholar 

  • O'Leary D, Costello F (2001) Personality and outcome in depression: an 18-month prospective follow-up study. J Affect Disord 63: 67–78

    Article  PubMed  Google Scholar 

  • Peselow ED, Robins CJ, Sanfilipo MP, Block P, Fieve RR (1992) Sociotropy and autonomy: relationship to antidepressant drug treatment response and endogenous-nonendogenous dichotomy. J Abnorm Psychol 101: 479–486

    PubMed  Google Scholar 

  • Peters UH (1985) Typus melancholicus. In: Fredman AM, Kaplan HI, Saddock BJ, Peters UH (Hrsg) Psychiatrische Praxis und Klinik, Bd 2. Thieme, Stuttgart

    Google Scholar 

  • Petersen T, Hughes M, Papakostas G, Kant A, Fava M, Rosenbaum JF, Nierenberg AA (2002) Treatment-resistant depression and Axis II comorbidity. Psychother Psychosom 71: 269–274

    Article  PubMed  Google Scholar 

  • Pfohl B, Stangl D, Zimmerman M (1984) The implications of DSM-III personality disorders for patients with major depression. J Affect Disord 7: 309–318

    Article  PubMed  Google Scholar 

  • Pfohl B, Coryell W, Zimmerman M, Stagl D (1987) Prognostic validity of self-report and interview measures of personality disorder in depressed patients. J Clin Psychiatry 48: 468–472

    PubMed  Google Scholar 

  • Philipp M, Maier W (1988) Psychopathologische Prädiktion der ambulanten Doxepin-Response: ein Replikationsversuch. Nervenarzt 59: 482–487

    PubMed  Google Scholar 

  • Philipp M, Beck V, Scherhag R, Glocke M, Schmidt R (1986) Biological and psychopathological prediction of response to doxepin in depressive outpatients. Pharmacopsychiatry 19: 262–263

    Google Scholar 

  • Pilkonas PA, Frank EL (1988) Personality pathology in recurrent depression: Nature, prevalence and relationship to treatment response. Am J Psychiatry 145: 435–441

    Google Scholar 

  • Pope HG, Jonas JM, Hudson JI, Cohen BM, Gunderson JG (1983) The validity of DSM-III borderline personality disorder. Arch Gen Psychiatry 40: 23–30

    PubMed  Google Scholar 

  • Reich JH (1990) The effect of DSM-III personality disorders on outcome of tricyclic antidepressant-treated nonpsychotic outpatients with major or minor depressive disorder. Psychiatry Res 32: 175–181

    Article  PubMed  Google Scholar 

  • Reich JH, Green AI (1991) Effect of personality disorders on outcome of treatment. J Nerv Ment Dis 179: 74–82

    PubMed  Google Scholar 

  • Roose SP, Glassman AH, Walsh T, Woodring S (1986) Tricyclic non-responders: Phenomenology and treatment. Am J Psychiatry 143: 345–348

    PubMed  Google Scholar 

  • Rossi A, Mariaangeli MG, Butti G, Scinto A, Di Cicco I, Kalyvoka A, Petruzzi C (2001) Personality disorders in bipolar and depressive disorders. J Affect Disord 65: 3–8

    Article  PubMed  Google Scholar 

  • Russell JM, Kornstein SG, Shea MT, McCullough JP, Harrison WM, Hirschfeld RM, Keller MB (2003) Chronic depression and comorbid personality disorders: response to sertraline versus imipramine. J Clin Psychiatry 64: 554–561

    PubMed  Google Scholar 

  • Sato T, Sakado K, Sato S (1993) Is there any specific personality disorder or personality disorder cluster that worsens the short-term treatment outcome of major depression? Acta Psychiatr Scand 88: 342–349

    Google Scholar 

  • Sato T, Hirano S, Narita T, Kusunoki K, Kato J, Goto M, Sakado K, Uehara T (1999) Temperament and character inventory dimensions as a predictor of response to antidepressant treatment in major depression. J Affect Disord 56: 153–161

    Article  PubMed  Google Scholar 

  • Sauer H, Kick H, Minne HW, Schneider B (1986) Prediction of the amitriptyline response: psychopathology versus neuroendocrinology. Int Clin Psychopharmacol 1: 284–295

    PubMed  Google Scholar 

  • Schatzberg AF, Cole JO, Cohen BM, Altesman RI, Sniffin CM (1983) Survey of depressed patients who have failed to respond to treatment. In: Davis JM, Mass J (eds) The affective disorders. American Psychiatric Press, Washington DC

    Google Scholar 

  • Shawcross CR, Tyrer P (1985) Influence of personality on response to monoamine oxidase inhibitors an tricyclic antidepressants. J Psychiatr Res 19: 557–562

    Article  PubMed  Google Scholar 

  • Shea MT, Pilkonis PA, Beckham E, Collins JF, Elkin I, Sotsky SM, Docherty JP (1990) Personality disorders and treatment outcome in the NIMH treatment of depression collaborative research programm. Am J Psychiatry 147: 711–718

    PubMed  Google Scholar 

  • Stuart S, Simons AD, Thase ME, Pilkonis P (1992) Are personality assessments valid in acute major depression? J Affect Disord 24: 281–289

    Article  PubMed  Google Scholar 

  • Taylor S, McLean P (1993) Outcome profiles in the treatment of unipolar depression. Behav Res Ther 31: 325–330

    Article  PubMed  Google Scholar 

  • Tellenbach H (1983) Melancholie, 4. Aufl. Springer, Berlin Heidelberg New York Tokio

    Google Scholar 

  • Tölle R (1987) Persönlichkeit und Melancholie. Nervenarzt 58: 327–339

    PubMed  Google Scholar 

  • Tome MB, Cloninger CR, Watson JP, Isaac MT (1997) Serotonergic autoreceptor blockade in the reduction of antidepressant latency: personality variables and response to paroxetine and pindolol. J Affect Disord 44: 101–109

    Article  PubMed  Google Scholar 

  • Tyrer P, Seivewright H (1988) Studies of outcome. In: Tyrer P (ed) Personality disorders. Wright, London, pp 119–137

    Google Scholar 

  • Tyrer P, Steinburg D (1975) Symptomatic treatment of agoraphobia and social phobia. Br J Psychiatry 127: 163–168

    PubMed  Google Scholar 

  • Tyrer P, Casey P, Gall J (1983) Relationship between neurosis and personality disorder. Br J Psychiatry 142: 404–408

    Google Scholar 

  • Ulusahin A, Ulug B (1997) Clinical and personality correlates of outcome in depressive disorders in a Turkish sample. J Affect Disord 42: 1–8

    Article  PubMed  Google Scholar 

  • Weissman MM, Prusoff BA, Klerman GL (1978) Personality and the prediction of long-term outcome of depression. Am J Psychiatry 135: 797–800

    PubMed  Google Scholar 

  • Wenning B, Saß H, Herpertz SC (2002) Zum Zusammenhang von depressiven Erkrankungen und Persönlichkeitsstörungen. Persönlichkeitsstörungen 4: 230–242

    Google Scholar 

  • West ED, Dally PJ (1959) Effect of iproniazid in depressive syndromes. BMJ 1: 1491–1494

    Google Scholar 

  • Zerssen D von (1982) Personality and affective disorders. In: Paykel ES (ed) Handbook of affective disorders. Churchill Livingstone, Edingburgh

    Google Scholar 

  • Zerssen D von, Pfister H von, Koeller DM (1988) The Munich Personality Test (MPT) — a short questionnaire for self-rating and relatives rating of personality traits, formal properties and clinical potential. Eur Arch Psychiatry Neurol Sci 238: 73–93

    PubMed  Google Scholar 

  • Zimmerman M, Coryell W, Pfohl B, Corenthal C, Stangl D (1986) ECT response in depressed patients with and without a DSM-III personality disorder. Am J Psychiatry 143: 1030–1032

    PubMed  Google Scholar 

  • Zuckerman DM, Prusoff BA, Weissman MM, Padian NS (1980) Personality as a predictor of psychotherapy and pharmacotherapy outcome for depressed patients. J Consult Clin Psychol 48: 730–735

    Article  PubMed  Google Scholar 

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  1. H. Ebel
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  2. C. Algermissen
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  3. H. Saß
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  1. Klinik für Psychatrie und Psychotherapie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Schumannstr. 20/21, 10117, Berlin

    Michael Bauer  & Mazda Adli  & 

  2. Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité — Universitätsklinik Berlin, Campus Charité Mitte (CCM), Luisenstr. 57, 10117, Berlin

    Anne Berghöfer

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Ebel, H., Algermissen, C., Saß, H. (2005). Bedeutung prämorbider Persönlichkeitsstrukturen für die Entwicklung therapieresistenter Depressionen. In: Bauer, M., Berghöfer, A., Adli, M. (eds) Akute und therapieresistente Depressionen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-28049-9_3

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