The role of axis II disorders in prognosis and response to CBT in recurrent depression

The role of axis II disorders in prognosis and response to CBT in recurrent depression Prof. Claudi L.H. Bockting, PhD (1) Affiliation: (1) University of Groningen, Department of Clinical Psychology, The Netherlands Depression is a recurring disease, especially in patients with a co-morbid personality disorder. Preventive Cognitive Therapy (CT) applied after remission, appears to be an effective strategy to prevent relapse in recurrently depressed patients (for a meta-analysis see Vittengl et al, 2007). This presentation focuses on the prevalence of personality disorders and predictive value of having an axis II disorder in terms of response on preventive CT (as assessed using the PDQ-4R, after adjustment for SCID-II criteria). Personality pathology was assessed in 172 euthymic patients with recurrent depression within a randomized trial comparing Preventive Cognitive therapy versus treatment as usual. Prospectively relapse and recurrence was assessed over 5,5 years follow-up (using the SCID-I, Bockting et al., 2009). In this study 46.7% of the remitted recurrently depressed patients had at least one of the axis II disorders. Having a co-morbid personality disorder did not predict poor response on preventive CT (time to relapse and recurrence, p=0.019). Patients with borderline personality disorder profit more from an eight session preventive CT than patients that did not have a co-morbid axis II disorder.