A comparison of self-concept and personality disorders in women with pain accounted for by psychological factors, women with major depression, and healthy controls

Objective: Do patients with pain accounted for by psychological factors (P) differ in their self-concept and personality disorders from patients with major depression (D) and healthy controls (C)? Method: Thirty hospitalized P-patients (DSM-IV, 307.80) and 30 hospitalized D-Patients (DSM-III-R) were given the Beck Depression Inventory on admission (BDI-1) and at discharge (BDI-2). Together with BDI-2, patients filled out the Personality Disorder Questionnaire for DSM-III-R (PDQR) and the Frankfurt Self-Concept Scales (FSKN). Thirty-two healthy comparisons (C) completed the same questionnaires. Results: BDI-2 showed no significant differences between groups P and D, a prerequisite for the comparison of psychological traits. PDQR differed in the three groups. D showed more dependent, obsessive-compulsive, and histrionic personality features than group P. The three groups differed in FSKN total score and all 10 subscales (C (healthiest self-concept) > P > D). Groups P and D were different (P > D) in total score and subscales: performance, problem coping, confidence in behavior and decision taking, and self-esteem. Ten P-patients with pathological BDI-2 (P-D) had significantly more disturbed PDQR and FSKN scores than the non-depressed (P-ND), and closely resembled the D-patients. Conclusions: Personality disorders and self-concept are not homogenous in female patients with P. Subgroup P-ND differs from patients with depression (fewer personality disorders, better self-concept), whereas subgroup P-D closely resembles them.