PERSONALITY-DISORDERS ASSOCIATED WITH GENERALIZED ANXIETY, PANIC, AND RECURRENT DEPRESSIVE-DISORDERS

Using a structured interview, the Personality Disorder Examination, the authors examined DSM-III-R personality disorders in 37 patients with generalized anxiety disorder [GAD], 40 with panic disorder [PD], and 38 with recurrent major depressive disorder [RD] in order to delineate personality disorders associated with these Axis I diagnoses. A higher proportion of PD than GAD and RD patients met criteria for one or more personality diagnosis [50 % vs. 41 % and 34 %, respectively], and PD patients had a greater variety of personality disorders. Disorders within the "anxious cluster"-especially avoidant and dependent personality patterns-were the most common in all three groups of patients. It is especially noteworthy that avoidant personality was equally represented in all, PD as well as GAD or RD, suggesting that avoidant patterns are associated not only with panic attacks that characteristically lead to phobic behavior, but also with free-floating anxiety and depression. Although the findings in panic and depressive disorders are in the expected direction from the existing literature on these disorders, those in generalized anxiety disorder are somewhat at variance with the conceptualization of generalized anxiety as being distinct from panic disorder. Overall, these data are compatible with the hypothesis of a shared diathesis in the three disorders; alternatively, the anxious cluster of personalities can be considered as nonspecific concomitants or sequelae of anxiety and depressive disorders.