Depressive personality and dysthymia: evaluating symptom and syndrome overlap.

Abstract:

BACKGROUND:Depressive Personality (DP) is being evaluated for future inclusion in DSM. One recurring issue has been conceptual and empirical redundancy with Dysthymia (i.e., Dysthymic Disorder; DD). METHODS:The symptom and syndrome overlap of DP and DD were tested in a clinical sample (N = 125) using both self-report and clinician ratings. RESULTS:Confirmatory factor analyses of the DP and DD symptoms indicated that models which separate these two syndromes had a better fit than a model in which all symptoms were classified together, particularly for the clinician-rated data. At the same time, the syndromes were highly correlated. Binary diagnostic analysis showed that over 80% of the individuals meeting criteria for DP also met criteria for DD. As predicted, the best fit was obtained when the 'psychological' symptoms of DD-- low self-esteem and feelings of hopelessness-- were allowed to be part of both syndromes, and 82% of patients who met criteria for both DP and DD endorsed these two symptoms. LIMITATIONS:Clinical ratings rather than structured diagnostic interviews were used. As well, some models required modification to improve fit. CONCLUSIONS:Depressive personality traits can be empirically separated from DD symptoms, but including DP as a categorical diagnosis would lead to a high degree of diagnostic overlap. Much of this overlap is due to sharing psychological features in common. Revisions in the diagnostic system should find a way to incorporate depressive personality traits without insisting that they be diagnosed in a categorical manner.

journal_name

J Affect Disord

authors

Ryder AG,Schuller DR,Bagby RM

doi

10.1016/j.jad.2006.01.008

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

217-27

issue

2-3

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(06)00009-7

journal_volume

91

pub_type

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