Prognostic value of pathological personality traits for treatment outcome in anxiety and depressive disorders: the Leiden Routine Outcome Monitoring Study

Eeden, W.A. van; Hemert, A.M. van; Giltay, E.J.; Spinhoven, P.; Beurs, E. de; Carlier, I.V.E.

doi:doi:10.1097/NMD.0000000000001535

Persistent URL of this record https://hdl.handle.net/1887/3563713

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Medicine / Leiden University Medical Centre (LUMC)

Eeden, W.A. van; Hemert, A.M. van; Giltay, E.J.; Spinhoven, P.; Beurs, E. de; Carlier, I.V.E. (2022)

Prognostic value of pathological personality traits for treatment outcome in anxiety and depressive disorders: the Leiden Routine Outcome Monitoring Study

Article / Letter to editor

Previous studies have failed to take baseline severity into account when assessing the effects of pathological personality traits (PPT) on treatment outcome. This study assessed the prognostic value of PPT (Dimensional Assessment of Personality Pathology-Short Form) on treatment outcome (Brief Symptom Inventory [BSI-posttreatment]) among patients with depressive and/or anxiety disorders (N = 5689). Baseline symptom level (BSI-pretreatment) was taken into account as a mediator or moderator variable. Results showed significant effects of PPT on outcome, of which Emotional Dysregulation demonstrated the largest association (beta = 0.43, p < 0.001). When including baseline BSI score as a mediator variable, a direct effect (beta = 0.11, p < 0.001) remained approximately one-third of the total effect. The effects of Emotional Dysregulation (interaction effect beta = 0.061, p < 0.001) and Inhibition (interaction effect beta = 0.062, p < 0.001), but not Compulsivity or Dissocial Behavior,...Show morePrevious studies have failed to take baseline severity into account when assessing the effects of pathological personality traits (PPT) on treatment outcome. This study assessed the prognostic value of PPT (Dimensional Assessment of Personality Pathology-Short Form) on treatment outcome (Brief Symptom Inventory [BSI-posttreatment]) among patients with depressive and/or anxiety disorders (N = 5689). Baseline symptom level (BSI-pretreatment) was taken into account as a mediator or moderator variable. Results showed significant effects of PPT on outcome, of which Emotional Dysregulation demonstrated the largest association (beta = 0.43, p < 0.001). When including baseline BSI score as a mediator variable, a direct effect (beta = 0.11, p < 0.001) remained approximately one-third of the total effect. The effects of Emotional Dysregulation (interaction effect beta = 0.061, p < 0.001) and Inhibition (interaction effect beta = 0.062, p < 0.001), but not Compulsivity or Dissocial Behavior, were moderated by the baseline symptom level. PPT predicts higher symptom levels, both before and after treatment, but yields relatively small direct effects on symptom decline when the effect of pretreatment severity is taken into account.Show less

Pathological personality traits

depression

anxiety disorders

treatment outcome

Dimensional Assessment of Personality Pathology-Short Form (DAPP-SF)