Personality Pathology in Winter Depression: Prevalence and Treatment Trajectories in Cognitive-Behavioral Therapy and Light Therapy.
Study Goal
The researchers aimed to examine the effects of personality pathology on treatment trajectories in winter depression, comparing group cognitive-behavioral therapy (CBT-SAD) and light therapy.
Results Summary
Personality pathology did not predict changes in depression outcomes over time in either CBT-SAD or light therapy, suggesting it is not a negative prognostic indicator for these treatments. Both treatments were similarly effective regardless of personality pathology.
Population
Adults with Major Depression, Recurrent with Seasonal Pattern (174 participants).
Effective Dosage
Not specified
Duration
Pretreatment, weekly during treatment, posttreatment, and follow-ups one and two winters later.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
- | neutral | personality pathology | adults with Major Depression, Recurrent with Seasonal Pattern | 98/174 (56.3%) with any trait and 65/174 (37.4%) with any disorder | explored the prevalence | #1 |
- | neutral | Dependent personality | adults with Major Depression, Recurrent with Seasonal Pattern | 65/174 (37.4%) elevation, 43/174 (24.7%) trait, 22/174 (12.6%) disorder | was the most common elevation | #2 |
- | increase | baseline depression scores | adults with Major Depression, Recurrent with Seasonal Pattern | - | predicted higher baseline depression scores | #3 |
group cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) | no change | depression | adults with Major Depression, Recurrent with Seasonal Pattern | - | did not predict change in depression | #4 |
light therapy | no change | depression | adults with Major Depression, Recurrent with Seasonal Pattern | - | did not predict change in depression | #5 |
Personality disorders are highly comorbid with major depression; however, findings are mixed regarding their impact on depression treatment outcomes and trajectories. Limited research has studied personality pathology in winter depression, specifically. This study (1) explored the prevalence of personality pathology in winter depression and (2) examined its effects on winter depression treatment trajectories. Participants were 174 adults with Major Depression, Recurrent with Seasonal Pattern from a randomized clinical trial comparing group cognitive-behavioral therapy for seasonal affective disorder (CBT-SAD) and light therapy. Participants completed the Millon Clinical Multiaxial Inventory-III (MCMI-III; Millon et al., 1994) at baseline. The prevalence of MCMI-III-defined pathological personality traits and personality disorders in this sample was 98/174 (56.3%) with any trait and 65/174 (37.4%) with any disorder. Dependent was the most common elevation (65/174, 37.4%), trait (43/174, 24.7%), and disorder (22/174, 12.6%). Most participants with pathological personality elevations had only one personality disorder (58/174, 33.3%) and one pathological personality trait (82/174, 47.1%). Growth curve analysis revealed personality pathology predicted higher baseline depression scores, but the number of MCMI-III pathological personality elevations (i.e., traits and disorders) and personality disorders did not predict change in depression over the timeframe of pretreatment, weekly during treatment, posttreatment, and follow-ups one and two winters later in CBT-SAD or light therapy. Results suggest that personality pathology is not a negative prognostic indicator or prescriptive factor for winter depression treatment with CBT-SAD or light therapy, which may inform treatment algorithms and decision-making in practice.