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Am J Psychiatry 1995; 152:239-247
Copyright © 1995 by American Psychiatric Association
DSM-III-R axis II comorbidity in dysthymia and major depression
CM Pepper, DN Klein, RL Anderson, LP Riso, PC Ouimette and H Lizardi
Department of Psychology, State University of New York at Stony Brook 11794-2500.
OBJECTIVE: Dysthymia is generally believed to be associated with a high
rate of DSM-III-R axis II comorbidity. However, it is unclear whether this
rate is higher than that for other axis I disorders, how many dysthymic
patients have personality disorders, and what the most common co-occurring
axis II conditions are. METHOD: Ninety-seven outpatients with early-on-set
dysthymia and 45 with episodic major depression were administered
structured diagnostic interviews for axis I and II disorders. In addition,
knowledgeable informants were independently interviewed about axis II
conditions in the patients. RESULTS: A significantly greater proportion of
dysthymic patients (60%) than patients with episodic major depression (18%)
met criteria for a personality disorder. The most common axis II conditions
among dysthymic patients were borderline, histrionic, and avoidant
personality disorder. Informants' reports yielded similar results.
CONCLUSIONS: These data indicate that early-onset dysthymia is associated
with significantly greater axis II comorbidity than episodic major
depression. Further work is necessary to elucidate the processes underlying
this association.
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