Dependent Personality Disorder Psychotherapies

No studies have been devoted solely to the treatment of dependent personality disorder, although some studies have included dependent personality disorder, suggesting a need for further case studies and controlled treatment trials to generate and test treatment hypotheses. In the Treatment of Depression Collaborative Research Program, three active treatments (imipramine, interpersonal psychotherapy, and cognitive-behavioral therapy) were compared with placebo plus clinical management over 16 weeks for the treatment of acute major depressive disorder. Patients with anxious-cluster personality disorders, including dependent personality disorder, had a lower attrition rate (28%) than other personality disorder groups. Significant improvement in depressive symptoms occurred in those both with and without personality disorders. However, complete remission occurred in fewer of the patients with anxious-cluster disorders (33%) than in those without a personality disorder (49%). The former also showed worse social adjustment. There were no clear-cut differential responses to type of treatment. Thus, patients with dependent personality disorder who become depressed may respond to treatment, but on return to baseline, some symptoms and social adjustment problems remain. Two other studies of depression had similar findings for personality disorders.

Two recent meta-analyses of the effectiveness of psychotherapy for personality disorders found several studies with a median of 25% (range = 10%-33%) of individuals with dependent personality disorder and others with large proportions of unspecified Cluster C disorders. The therapies had medium to large positive effects for individual, group, day, and residential treatments. This highlights the conclusion reached by one expert panel that the treatment of dependent personality disorder is generally successful.