The impact of comorbid personality difficulties on response to IAPT treatment for depression and anxiety

Elizabeth Goddard, Janet Wingrove, Paul A Moran*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

69 Citations (Scopus)
562 Downloads (Pure)


The UK's Improving Access to Psychological Therapies (IAPT) initiative provides evidence-based psychological interventions for mild to moderate common mental health problems in a primary care setting. Predictors of treatment response are unclear. This study examined the impact of personality disorder status on outcome in a large IAPT service. We hypothesised that the presence of probable personality disorder would adversely affect treatment response. Method: We used a prospective cohort design to study a consecutive sample of individuals (n = 1249). Results: Higher scores on a screening measure for personality disorder were associated with poorer outcome on measures of depression, anxiety and social functioning, and reduced recovery rates at the end of treatment. These associations were not confounded by demographic status, initial symptom severity nor number of treatment sessions. The presence of personality difficulties independently predicted reduced absolute change on all outcome measures. Conclusions: The presence of co-morbid personality difficulties adversely affects treatment outcome among individuals attending for treatment in an IAPT service. There is a need to routinely assess for the presence of personality difficulties on all individuals referred to IAPT services. This information will provide important prognostic data and could lead to the provision of more effective, personalised treatment in IAPT.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalBehaviour Research and Therapy
Publication statusPublished - 1 Oct 2015

Bibliographical note

Date of Acceptance: 14/04/2015


  • Anxiety
  • Cognitive behaviour therapy
  • Depression
  • IAPT
  • Personality disorder
  • Treatment outcome


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