Correlates of personality in panic disorder patients

Considerationof Personality Factors in Psychopathology

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PERSONALITY, DEPRESSION RESPONSE Russell T. Joffe, Joseph Regan

BIOL PSYCHIATRY 1989;25:1OA-13A

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AND ANTIDEPRESSANT

Toronto, Canada The relationship between personality and depression is complex. In order to further investigate this, we examined personality measures before and after antidepressant treatment in 42 subjects with nonpsychotic, unipolar major depression according to Research Diagnostic Criteria. Personality features and diagnoses were evaluated using Millon Clinical Multiaxial Inventory which provides diagnoses congruent with DSMIII. Antidepressant response was associated with significant alterations in personality scale scores and the frequency of personality disorder diagnosis. Mean antisocial and paranoid personality scale scores differentiated responders from non-responders to the first antidepressant treatment. Clinical and theoretical implications of these findings are discussed.

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THE EFFECT OF STARVATION ON PERSONALITY AND PSYCHIATRIC DIAGNOSES Katherine A. Halmi, Edward Schork, Ronald Marcus

PROFILES

White Plains, NY Anorexia nervosa patients completed a standardized test of psychopathology, the MMPI, and a standardized interview for psychiatric diagnoses, the DIS, in a follow up study conducted ten years after they were hospitalized for anorexia nervosa. Regression analysis showed that four of the MMPI scales F, K, 6, and 0 together explained 29% of the variance in body weight; persons who weighed less were more paranoid, more socially withdrawn, more defensive and less open about their problems. Those patients who had recovered had a significantly lower life-time prevalence rate of unipolar depression compared with those patients who still had symptoms. In another study anorexia nervosa patients completed a standardized personality disorder interview, the PDE, before and after a hospital treatment program. Anorectic-restrictor patients actually met more criteria for Axis II personality diagnoses after weight gain in contrast to anorectic-bulimic patients who met fewer criteria after weight gain. The results show (1) that some personality and behavioral characteristics are associated with weight status in anorectic patients, (2) unipolar depression is a deterring factor for recovery from anorexia nervosa, and (3) anorectic-restrictor and anorectic-bulimic patients respond differently to a standardized interview for personality disorder.

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CORRELATES OF PERSONALITY IN PANIC DISORDER PATIENTS Matig Mavissakalian, Mary Sue Hamann Columbus. OH One hundred eighty-seven patients meeting DSM-III criteria for panic disorder (N = 26) or agoraphobia with panic (N = 161) were assessed with the Personality Diagnostic Questionnaire, a self-rating scale designed to assess Axis II personality disorders and

BIOL PSYCHIATRY 1989:25:IOA-13A

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Considerationof Personality Factors in Psychopathology

traits. Results replicated our earlier findings of a preponderance of dependent, avoidant, and histrionic features and the finding that patients exhibiting a greater number of personality traits were also significantly more symptomatic. Patients with the diagnosis of panic disorder did not differ on any personality disorder variables from patients with the diagnosis of agoraphobia with panic, Furthermore, none of the specific symptom dimensions, i.e., panic, anxiety, or agoraphobia, was selected as a unique predictor of any personality variables in the regression analyses. Rather, the most important correlates of personality disorder in these patients consisted of general factors such as dysphoric mood, social phobia or interpersonal sensitivity, and Eysenck’s neuroticism dimension. The results are discussed in light of recent findings suggesting a nonspecific link between panic disorder or agoraphobia and personality disorder.

2.5 PERSONALITY ASSESSMENT USING THE TRIDIMENSIONAL PERSONALITY QUESTIONNAIRE (TPQ) IN PATIENTS WITH PANIC DISORDER AND GENERALIZED ANXIETY DISORDER Mark D. Fossey, Peter P. Roy-Byrne, Deborah S. Cowley, R.B. Lydiard, Michele T. Laraia, Joseph J. Zealberg, James C. Ballenger Charleston,

SC, and Seattle, WA

Thirty-one patients with PD and 28 patients with GAD were assessed with the TPQ. Results were compared with Cloninger’s normative data. PD and GAD patients had significantly elevated scores on total harm avoidance (p = .Ol). Female patients with PD and GAD had significantly lower scores on total reward dependence (p = .Ol) while female PD patients had elevated total novelty seeking scores (p = .05). Males with GAD had high total novelty seeking scores (p = .05) and low total reward dependence scores (p = .05). No significant differences were noted between diagnostic categories or by sex within diagnostic categories. PD patients with agoraphobia had significantly higher scores on the harm avoidance subscale for fatigability and asthenia compared to those without agoraphobia (p = .05). No subscale correlated with HamA scores. These findings suggest that personality is not significantly different between patients with GAD and PD although significant differences exist between these anxiety patients and normative data.

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BENZODIAZEPINE SENSITIVITY AND PERSONALITY NORMAL SUBJECTS Deborah S . Cowley , Peter P. Roy-Byrne, Daniel Hommer

IN

Seattle, WA

Panic disorder has been associated with high harm avoidance (HA) scores on the Tridimensional Personality Questionnaire (TPQ). We have shown preliminary evidence for GABA,-benzodiazepine receptor subsensitivity in patients with panic disorder versus normal controls. Here, we examine the relationship of TPQ scores with benzodiazepine sensitivity in normal subjects. Eleven normals (4M, 7F aged 20-36) were given four logarithmically increasing doses of IV diazepam and their saccadic eye movement velocity (SEMV), memory, self-rated sedation and anxiety measured. At