Objective. The aim of the present study is to evaluate the link between the age of onset of mood disorders and the complexity of the personality traits. Methods. 209 patients with major depressive or manic/hypomanic episodes were assessed using the Structured Clinical Interview for DSM Axis I diagnoses and the Millon Clinical Multiaxial Inventory-III (MCMI-III). Results. 17.2% of the patients had no elevated MCMI-III scores, 45.9% had one peak, and 36.9% had a complex personality disorder with two or more elevated scores. Mood disorders onset of 29 years or less was the variable most related to the complexity of personality disorders as indicated from a recursive partitioning analysis. Conclusions. The relationship between mood disorders and personality traits differ in reference to age of onset of the mood disorder. In younger patients, maladaptive personality traits can evolve both in a mood disorder onset and in a complex personality disorder, while the later development of a severe mood disorder can increase the personality symptomatology. Our results suggest a threshold of mood disorder onset higher compared to previous studies. Maladaptive personality traits should be assessed not only during adolescence but also in young adults to identify and treat potential severe mood disorders. 1. Introduction Mood disorders (MD) such as depression and bipolar disorders are one of the most disabling types of diseases [1]. In 2004, depression was the leading cause of disability as measured by years lost due to disability (YLD) and the 3rd leading contributor to the global burden of disease assessed using the disability-adjusted life year (DALY), a time-based measure that combines years of life lost due to premature mortality and years of life lost due to time lived in states of less than full health [2]. Bipolar disorder was one of the top 10 leading global causes of YLD in 2004 [2]. Presence of risk factors (e.g., excessive nicotine use and alcohol and other drug use), cooccurring anxiety disorders, and eating disorders can lead to the early development of severe medical conditions [3]. Also personality disorders (PD) are a class of disorders that can significantly worsen a patient’s quality of life. In fact, psychosocial impairment is one of the diagnostic criteria for personality disorders according to the DSM IV [4] and there is empirical evidence that the most severe personality disorders (e.g., schizotypal personality disorder and borderline personality disorder) are a major cause of psychosocial disability compared to unipolar depression without
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