Depression and Personality: Conceptual and Clinical Challenges

Depression and Personality: Conceptual and Clinical Challenges offers an intriguing new look at where we are in understanding the relationship between personality dimensions, disorders, and mood disorder. It is both a cogent update of conceptual models and a clearly written, practical guide to the challenges faced every day by clinicians as they treat patients with depression and bipolar disorder.

In introducing the volume, the editors emphasize the value of robust pharmacotherapy -- augmented by psychosocial interventions focused on assets, rather than liabilities, of a patient's personality. They also stress the importance of a detailed review of our understanding -- conceptually and clinically -- of the relationship between personality and depression. In the 10 subsequent chapters, 22 authors examine the impact of personality on pharmacotherapy and review crucial issues of assessment and therapy for personality disorder patients with comorbid depression, chronic depression, and bipolar disorder. Similar issues of the occurrence of these illnesses in adolescents and the elderly are also addressed.

Invaluable reading for clinicians and researchers alike, Depression and Personality: Conceptual and Clinical Challenges offers fascinating perspectives on the historical antecedents, neurobiological dimensions, and conceptual models of the relationship between personality and depression.

American Psychiatric Publishing

Depression and Personality: Conceptual and Clinical Challenges offers an intriguing new look at where we are in understanding the relationship between personality dimensions, disorders, and mood disorder. It is both a cogent update of conceptual models and a clearly written, practical guide to the challenges faced every day by clinicians as they treat patients with depression and bipolar disorder.

Laying the groundwork for subsequent chapters, the editors emphasize the value of not only robust pharmacotherapy augmented by psychosocial interventions (with a focus on the assets rather than the liabilities of a patient's temperament), but also of a detailed review of where we are today.

An introductory overview provides valuable historical perspective on the evolution of personality from "humors" to body constitution and temperament. In 10 informative chapters, 22 contributors discuss

• The neurobiological dimensions of personality, focusing on affect-related traits as they review the evidence for serotonin and norepinephrine disturbance based on challenge paradigms, and the range of models to understand the interrelationship between personality and depression.
• The justification for depressive personality in both categorical terms, i.e., adding to the diagnostic armamentarium of DSM-V, and dimensional terms, focusing on the Five Factor Model to provide a link between several facets of neuroticism and depressive personality disorder.
• The impact of personality on various aspects of treatment, filling in a gap in the pharmacotherapy literature by asserting that personality pathology can affect the patient's capacity to seek, be engaged in, or be compliant with treatment.
• Key assessment and treatment issues, recommending a multimodal phased treatment approach that involves targeted pharmacotherapy and integrated individual psychotherapy.
• The role of personality disorder in the assessment and treatment of chronic depression, with a concise, practical overview of medication and psychotherapy issues regarding the role of Axis II disorders, and the complex relationship between bipolar disorder and personality factors.
• The complexity involved in adolescent depression with personality disorder, providing a conceptual framework for understanding what factors of personality contribute to vulnerability for depression in adolescents, and depression in later life, including particularly relevant issues such as the role of physical illness and organic factors on the clinical presentation of personality and affective disorder

Invaluable reading for clinicians and researchers alike, Depression and Personality: Conceptual and Clinical Challenges offers fascinating perspectives on the historical antecedents, neurobiological dimensions, and conceptual models regarding the relationship between personality and depression.

Doody Review Services

Reviewer:Patricia E. Murphy, PhD(Rush University Medical Center)
Description:This edited volume provides a comprehensive overview of issues and research relating affective disorders and personality disorders.
Purpose:The book aims to improve treatment of patients with both Axis I and Axis II issues with a sense that "the patient is better served if the characterologic manifestations are viewed as part of the affective illness." Authors with various expertise offer information that addresses this serious need.
Audience:Research on pharmacology as well as psychotherapy makes this a valuable book for psychiatrists. Therapists who work with psychiatric patients would benefit from the perspective and research in this book. Residents or students in training would also find the material interesting and readable.
Features:The book flows smoothly with themes from the earlier chapters on psychobiology and temperament woven into content in subsequent chapters. A balanced, critical report of research leaves the reader with a sense of some fairly good evidence to help explicate the impact personality can have on issues of treatment. At the same time, limitations in research demonstrate how much remains to be explored. There are some cases to illustrate diagnosis and treatment, but the contribution of the book is its strong theoretical approach which can enhance the clinician's approach to treatment with this population.
Assessment:To my knowledge, this is the most concise presentation of the genetic, biological, environmental, interpersonal, and psychosocial factors that impinge on persons who might not respond well to treatment for depression because of underlying personality structures. This is a very important contribution that offers new hope in work with these people. The busy clinician will find the content in this well-organized book easily accessible.

Michael Rosenbluth, M.D., is Assistant Professor of Psychiatry at the University of Toronto and Director of the Psychiatric Rehabilitation Treatment Program at Toronto East General Hospital in Toronto, Ontario.

Sidney H. Kennedy, M.D., is Professor of Psychiatry at the University of Toronto and Psychiatrist-in-Chief of the University Health Network in Toronto, Ontario.

R. Michael Bagby, Ph.D., is Professor of Psychiatry at the University of Toronto and Director of Clinical Research at the Centre for Addiction & Mental Health in Toronto, Ontario.