Personality Disorders in Patients with Major Depressive Disorder and Association to Suicide

Abstract Major depressive disorder ranks as the fourth leading cause of disability worldwide and is one of the most common psychiatric disorders. Personality disorders, though less common than MDD, also appear highly prevalent. Several studies have examined the prevalence of suicidal behaviors in patients with MDD, but the prevalence range varied widely from 7.3to 48.4%. Objective of the Study This study aimed to assess type of PD among MDD patients, study the association between presence of PD co-morbid with MDD and level of functioning of the patients, investigate the relationship between PDs and risk of suicide in patients with MDD. Patients and Methods This Cross-sectional observational study included 120 patients diagnosed as MDD according to SCID-I assessment DSM IV were recruited then they were assessed severity of depression using Hamilton Depression Rating Scale and tested for the presence of Personality Disorders using SCID-II and assessed level of functioning according to GAF, and suicidality using Columbia- Suicide Severity Rating Scale assessment. Results Comorbid personality disorder was detected in 67.5% of patients (16.6% of patients had single comorbid personality disorder, while 50.8% of patients had Mixed PD). The most diagnosed PDs were Cluster B PDs (borderline personality disorder and narcissistic personality disorder) followed by Cluster C PD avoidant personality disorder (73.3%, 66.7%, 54.2% of patients respectively). Mixed PD had significant effect on level of functioning GAF of the MDD patients. Mixed PD had significant effect on suicidal thoughts and suicidal attempts. Conclusion Personality disorders showed significant impact on mental health status particularly depressive manifestations. Moreover, personality disorders and MDD exert marked effect on patients’ functionality and increase chance of suicidality.