Effect of Personality Traits on Sustained Remission Among Patients with Major Depression: A 12-Month Prospective Study

Abstract

Purpose

Major depression is a heterogeneous disorder. Therefore, careful evaluation and comprehensive assessment are crucial elements for achieving remission. Personality traits influence prognosis and treatment outcomes, but there is not enough evidence on the association between personality traits and sustained remission (SR). Hence, the present study aimed to evaluate the relationship between personality traits and SR among patients with major depression.

Patients and Methods

The 12-month prospective study evaluated 77 patients diagnosed with major depressive disorder. All patients underwent a comprehensive assessment, including the Temperament and Personality Questionnaire (T&P) at baseline, and depression severity was measured at baseline as well as six and 12 months. SR was defined as remission (the GRID-Hamilton Depression Rating Scale [GRID-HAMD₁₇] score ≦ 7) at both the 6- and 12-month follow-up. We compared eight T&P construct scores at baseline between the SR and non-SR groups. Multivariable logistic regression analyses were performed to determine the T&P personality traits related to SR.

Results

Patients who achieved SR had a lower T&P personal reserve and lower T&P rejection sensitivity. Further, lower scores on the T&P personal reserve trait were independently associated with higher rates of SR among patients with major depression. Patients who achieved SR had a shorter duration of the current depressive episode and milder severity of depression at baseline.

Conclusion

A lower level of personal reserve predicted a higher probability of SR in the treatment of depression. Extended observations in naturalistic follow-up settings with larger sample sizes are required to better understand the personality traits affecting SR in patients with depression.

Keywords:

• depression
• personality traits
• personal reserve
• sustained remission
• temperament and personality questionnaire

Abbreviations

aOR, Adjusted Odds Ratio; BDI-II, Beck Depression Inventory-Second Edition; CBT, cognitive behavioral therapy; DAS-24, Dysfunctional Attitudes Scale; DSM-IV, Diagnostic and Statistical Manual of Mental Disorders-IV; GRID-HAMD₁₇, GRID-Hamilton Depression Rating Scale; SR, sustained remission; T&P, Temperament and Personality Questionnaire.

Ethics Approval and Informed Consent

This study was approved by the Research Ethics Committee of Keio University School of Medicine, Gunma Hospital and Toyosato Hospital, and was conducted in accordance with the tenets of the Declaration of Helsinki. Informed consent was obtained from each patient prior to enrolment in the study.

Acknowledgments

We would like to thank Dr. Dai Mitsuda, Mses. Sayaka Odagiri, Mire Ozawa, Erika Hyo and Yoshie Taguchi, and Mr. Shunsuke Kido for assistance with the study management. We also would like to thank Editage for English language editing.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Prof. Dr. Masaru Mimura reports personal fees from Biogen Japan, personal fees from Byer Pharmaceutical, grants, personal fees from Daiichi Sankyo, personal fees from Dainippon-Sumitomo Pharma, personal fees from Demant Japan, grants, personal fees from Eisai, personal fees from Eli Lilly, personal fees from Fuji Film RI Pharma, personal fees from Hisamitsu Pharmaceutical, personal fees from H.U. Frontier, personal fees from Janssen Pharmaceutical, personal fees from Mochida Pharmaceutical, personal fees from MSD, personal fees from Mylan EPD, personal fees from Nippon Chemipher, personal fees from Novartis Pharma, personal fees from Ono Yakuhin, personal fees from Otsuka Pharmaceutical, personal fees from Pfizer, grants from Shionogi, grants from Takeda Yakuhin, personal fees from Teijin Pharma, personal fees from Viatris, personal fees from Fronteo, grants from Tanabe Mitsubishi, grants from Tsumura, outside the submitted work. All authors declare that they have no conflicts of interest regarding this study.

Additional information

Funding

This study was funded by Japan Agency for Medical Research and Development (AMED grant No. JP21dk0307084) and in part by the MGH-SAFER grant. The funders had no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication.