Borderline personality traits do not influence response to TMS.

Background: Depression is common in the primary care setting and tobacco use is more prevalent among individuals with depression. Recent research has linked smoking to poorer outcomes of depression treatment. We hypothesized that in adult primary care patients with the diagnosis of depression, current smoking would have a negative impact on clinical outcomes, regardless of treatment type (usual primary care [UC] vs collaborative care management [CCM]). Methods: A retrospective chart review study of 5155 adult primary care patients with depression in a primary care practice in southeast Minnesota was completed. Variables obtained included age, gender, marital status, race, smoking status, initial Patient Health Questionnaire-9 (PHQ-9), and 6-month PHQ-9. Clinical remission (CR) was defined as 6-month PHQ-9 <5. Persistent depressive symptoms (PDS) were defined as PHQ-9 ≥10 at 6 months. Treatment in both CCM and UC were compared. Results: Using intention to treat analysis, depressed smokers treated with CCM were 4.60 times as likely (95% CI 3.24-6.52, P < .001) to reach CR and were significantly less likely to have PDS at 6 months (adjusted odds ratio [AOR] 0.19, 95% CI 0.14-0.25, P < .001) compared with smokers in UC. After a 6-month follow-up, depressed smokers treated with CCM were 1.75 times as likely (95% CI 1.18-2.59, P = .006) to reach CR and were significantly less likely to have PDS (AOR 0.45, 95% CI 0.31-0.64, P < .001) compared with smokers in UC. Conclusions: CCM significantly improved depression outcomes for smokers at 6 months compared with UC. However, in the UC group, smoking outcomes were not statistically different at 6 months for either remission or PDS. Also, nonsmokers in CCM had the best clinical outcomes at 6 months in both achieving clinical remission and reduction of PDS when compared with smokers in UC as the reference group.

https://journals.sagepub.com/doi/pdf/10.1177/2150132719861265

Depression Outcomes in Smokers and Nonsmokers: Comparison of Collaborative Care Management Versus Usual Care.

The role of lithium treatment on comorbid anxiety symptoms in patients with bipolar depression.

Update the evidence regarding how co-occurring personality disorders influence treatment outcomes for major depressive disorder and update the evidence regarding treatment options for personality disorders that are co-occurring with major depressive disorder. There is evidence that personality disorders can be effectively treated through a variety of psychotherapeutic modalities. Given the substantial evidence that co-occurring personality disorders impede the recovery from major depressive disorder, comprehensively addressing any co-occurring personality disorders is an essential part of an effective treatment plan for patients with major depressive disorder. Personality disorders such as borderline personality disorder, which is commonly co-occurring with major depressive disorder, have several validated treatment options. Since publication of past reviews on the topic, there have been multiple additional studies published to advance the discussion of the impact of personality disorders on treatment outcomes in major depression. There is now substantial evidence that personality disorders can negatively affect treatment outcomes in the setting of major depression, which is consistent with the clinical observation that co-occurring personality disorders need to be comprehensively addressed to achieve optimal outcomes for the individual. There also now exists substantial evidence that personality disorders can be effectively treated using several validated psychotherapeutic modalities. It is recommended that a comprehensive assessment, including assessment for co-occurring personality disorders, is implemented in all cases of major depressive disorder that have not been successfully treated. In those cases where a co-occurring personality disorder is identified, specific treatment for the personality disorder should be recommended.

Prognostic Significance of Personality Disorders in Patients with Major Depressive Disorder

An Explorative Study of Atypical Social Interaction Styles in Adult Men with Autism Spectrum Disorder, Men with Personality Disorders and Men from the General Population

Background: Previous studies have suggested that having a comorbid personality disorder (PD) along with major depression is associated with poorer depression outcomes relative to those without como...

https://journals.sagepub.com/doi/pdf/10.1177/2150132718776877

Cesar Gonzales

Papers

Impact of Personality Disorder Cluster on Depression Outcomes Within Collaborative Care Management Model of Care.