Martina Balestri1, Stefano Porcelli1, Daniel Souery2, Siegfried Kasper3, Dimitris Dikeos4, Panagiotis Ferentinos4, George N Papadimitriou4, Dan Rujescu5, Giovanni Martinotti6, Marco Di Nicola7, Luigi Janiri7, Elisabetta Caletti8, Gian Mario Mandolini8, Alessandro Pigoni8, Riccardo Augusto Paoli8, Matteo Lazzaretti8, Paolo Brambilla8, Michela Sala9, Vera Abbiati10, Marcella Bellani11, Cinzia Perlini11, Maria Gloria Rossetti11, Sara Piccin12, Carolina Bonivento12, Dora Fabbro13, Giuseppe Damante13, Clarissa Ferrari14, Roberta Rossi15, Laura Pedrini15, Francesco Benedetti16, Stuart Montgomery17, Joseph Zohar18, Julien Mendlewicz19, Alessandro Serretti20. 1. Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy. 2. Laboratoire de Psychologie Médicale, Université Libre de Bruxelles, Centre Européen de Psychologie Médicale-PsyPluriel, Brussels, Belgium. 3. Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria. 4. Department of Psychiatry, Athens University Medical School, Athens, Greece. 5. University Clinic for Psychiatry, Psychotherapy and Psychosomatic, Martin-Luther-University Halle-Wittenberg, Germany. 6. Department of Neuroscience, Imaging, Scienze Cliniche, University "G.d'Annunzio", Chieti, Italy. 7. Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Catholic University of Sacred Heart, Rome, Italy. 8. Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy. 9. Department of Mental Health, Azienda Sanitaria Locale Alessandria, Alessandria, Italy. 10. Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. 11. Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy; UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Italy. 12. Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy. 13. Department of Laboratory Medicine, Institute of Medical Genetics, University of Udine, Italy. 14. Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio FBF, Brescia, Italy. 15. Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio FBF, Brescia, Italy. 16. Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy, University Vita-Salute San Raffaele, Milan, Italy. 17. Imperial College, University of London, London, United Kingdom. 18. Chaim Sheba Medical Center, Tel-Hashomer, Israel. 19. Université Libre de Bruxelles, Brussels, Belgium. 20. Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy. Electronic address: alessandro.serretti@unibo.it.
Abstract
BACKGROUND: personality features have been repeatedly associated with depression treatment outcome in Major Depressive Disorder (MDD), however conclusive results are still lacking. Moreover, as for Bipolar Disorder (BD), results are only few and preliminary. AIM: the aim of the present study was to perform an exploratory investigation of the influence of personality traits as assessed by the Temperament and Character Inventory (TCI), on principal depression treatment outcomes (non remission, non response and resistance). METHODS: 743 mood disorders patients (455 MDD (61.24%) and 288 BD (38.76%)) were recruited in the context of 6 European studies. Generalized logit models were performed to test the effects of TCI dimensions on treatment outcomes, considering possible confounders such as age, gender and education. Positive results were controlled for comorbidities (anxiety and substance use disorders) as well. RESULTS: MDD Non-Remitters showed high Harm Avoidance (HA) and Self Transcendence (ST) (p = 0.0004, d = 0.40; p = 0.007, d = 0.36 respectively) and low Persistence (P) and Self Directedness (SD) (p = 0.05; d = 0.18; p = 0.002, d = 0.40, respectively); MDD Non-Responders showed a slightly different profile with high HA and low Reward Dependence (RD) and SD; finally, MDD Resistants showed low RD, P and Cooperativeness (C). In BD patients, only higher HA in non response was observed. LIMITATIONS: the retrospective cross-sectional design, the TCI assessment regardless of the mood state and the small number of bipolar patients represent the main limitations. CONCLUSION: specific TCI personality traits are associated with depression treatment outcome in MDD patients. The inclusion of such personality traits, together with other socio-demographic and clinical predictors, could ameliorate the accuracy of the prediction models available to date.
BACKGROUND: personality features have been repeatedly associated with depression treatment outcome in Major Depressive Disorder (MDD), however conclusive results are still lacking. Moreover, as for Bipolar Disorder (BD), results are only few and preliminary. AIM: the aim of the present study was to perform an exploratory investigation of the influence of personality traits as assessed by the Temperament and Character Inventory (TCI), on principal depression treatment outcomes (non remission, non response and resistance). METHODS: 743 mood disorderspatients (455 MDD (61.24%) and 288 BD (38.76%)) were recruited in the context of 6 European studies. Generalized logit models were performed to test the effects of TCI dimensions on treatment outcomes, considering possible confounders such as age, gender and education. Positive results were controlled for comorbidities (anxiety and substance use disorders) as well. RESULTS:MDD Non-Remitters showed high Harm Avoidance (HA) and Self Transcendence (ST) (p = 0.0004, d = 0.40; p = 0.007, d = 0.36 respectively) and low Persistence (P) and Self Directedness (SD) (p = 0.05; d = 0.18; p = 0.002, d = 0.40, respectively); MDD Non-Responders showed a slightly different profile with high HA and low Reward Dependence (RD) and SD; finally, MDD Resistants showed low RD, P and Cooperativeness (C). In BD patients, only higher HA in non response was observed. LIMITATIONS: the retrospective cross-sectional design, the TCI assessment regardless of the mood state and the small number of bipolarpatients represent the main limitations. CONCLUSION: specific TCI personality traits are associated with depression treatment outcome in MDDpatients. The inclusion of such personality traits, together with other socio-demographic and clinical predictors, could ameliorate the accuracy of the prediction models available to date.