Depressive personality disorder
Personality disorders |
---|
Cluster A (odd) |
Cluster B (dramatic) |
Cluster C (anxious) |
Not otherwise specified |
Depressive |
Others |
Depressive personality disorder (also known as
Originally included in the
While depressive personality disorder shares some similarities with
Characteristics
The DSM-IV defines depressive personality disorder as "a pervasive pattern of depressive cognitions and behaviors beginning by early adulthood and occurring in a variety of contexts."[1] Depressive personality disorder occurs before, during, and after major depressive episodes, making it a distinct diagnosis not included in the definition of either major depressive episodes or dysthymic disorder. Specifically, five or more of the following must be present most days for at least two years in order for a diagnosis of depressive personality disorder to be made:
- Usual mood is dominated by dejection, gloominess, cheerlessness, joylessness and unhappiness
- Self-concept centres on beliefs of inadequacy, worthlessness and low self-esteem
- Is blamingand derogatory towards the self
- Is brooding and given to worry
- Is negativistic, critical and judgmental toward others
- Is pessimistic
- Is prone to feeling remorseful[1]
Studies in 2000-2002 have found more of a correlation between depressive personality disorder and dysthymia than a comparable group of people without depressive personality disorder.[3][4]
Millon's subtypes
Theodore Millon identified five subtypes of depression.[1][5] Any individual depressive may exhibit none, or one or more of the following:
Subtype | Description | Personality traits |
---|---|---|
Ill-humored depressive | Including negativistic features
|
Patients in this subtype are often hypochondriacal, cantankerous and irritable, and guilt-ridden and self-condemning. In general, ill-humored depressives are down on themselves and think the worst of everything. |
Self-derogating depressive | Including dependent features | Patients who fall under this subtype are self-deriding, discrediting, odious, dishonorable, and disparage themselves for weaknesses and shortcomings. These patients blame themselves for not being good enough. |
Morbid depressive | Including schizoid and masochistic features | Morbid depressives experience profound dejection and gloom, are highly lugubrious, and often feel drained and oppressed. |
Restive depressive | Including avoidant features | Patients who fall under this subtype are consistently unsettled, agitated, wrought in despair, and perturbed. This is the subtype most likely to commit suicide in order to avoid all the despair in life.[1] |
Voguish depressive | Including histrionic and narcissistic features | Patients who fall under this subtype embrace their suffering as ennobling. They view their personal depression as self-glorifying and dignifying; their unhappiness as a stylish expression of social disenchantment. |
Not all patients with a depressive disorder fall into a subtype. These subtypes are multidimensional in that patients usually experience multiple subtypes, instead of being limited to fitting into one subtype category. Currently, this set of subtypes is associated with melancholic personality disorders. All depression spectrum personality disorders are melancholic and can be looked at in terms of these subtypes.
DSM-5
Similarities to dysthymic disorder
Much of the controversy surrounding the potential inclusion of depressive personality disorder in the DSM-5 stems from its apparent similarities to
The key difference between dysthymic disorder and depressive personality disorder is the focus of the symptoms used to diagnose. Dysthymic disorder is diagnosed by looking at the
Comorbidity with other disorders
Many researchers believe that depressive personality disorder is so highly comorbid with other depressive disorders, manic-depressive episodes and dysthymic disorder, that it is redundant to include it as a distinct diagnosis. Recent studies however, have found that dysthymic disorder and depressive personality disorder are not as comorbid as previously thought. It was found that almost two thirds of the test subjects with depressive personality disorder did not have dysthymic disorder, and 83% did not have early-onset dysthymia.[1]
The comorbidity with Axis I depressive disorders is not as high as had been assumed. An experiment conducted by American psychologists showed that depressive personality disorder shows a high comorbidity rate with major depression experienced at some point in a lifetime and with any mood disorders experienced at any point in a lifetime. A high comorbidity rate with these disorders is expected of many diagnoses. As for the extremely high comorbidity rate with mood disorders, it has been found that essentially all mood disorders are comorbid with at least one other, especially when looking at a lifetime sample size.[7]
References
- ^ a b c d e f Millon, T. (2006). Personality subtypes. Retrieved from http://millon.net/taxonomy/summary.htm Archived 2013-10-23 at the Wayback Machine
- ^ )
- S2CID 8825180.
- PMID 11097962.
- ^ Millon, Theodore, Personality Disorders in Modern Life, 2004
- ^ University of Michigan Psychology Department, . (2006, January 20). Dysthymic disorder. Retrieved from http://www.med.umich.edu/depression/dysthymia.htm Archived 2010-02-27 at the Wayback Machine
- PMID 11772680.
Further reading
- Finnerty, Todd (2009). Depressive Personality Disorder: Understanding Current Trends in Research and Practice. Columbus, OH: WorldWideMentalHealth.com.
- Huprich, Steven K. (2009). What Should Become of Depressive Personality Disorder in DSM-V? Harvard Review of Psychiatry, 17:1,41-59.
- Millon, Theodore; Davis; Roger; Millon, Carrie (1997). MCMI-III Manual, 2nd edition. Minneapolis, MN: National Computer Systems.