Temperament and character traits predict future burden of depression

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• 作者：Tom Rosenstr&ouml ; m^a ; ^d ; ^{tom.rosenstrom@helsinki.fi" class="auth_mail} ; Pekka Jylhä ; ^b ; ^e ; C. Robert Cloninger^c ; Mirka Hintsanen^a ; ^h ; Marko Elovainio^a ; ^d ; Outi Mantere^b ; ^f ; ^g ; Laura Pulkki-Rå ; back^a ; Kirsi Riihimä ; ki^b ; Maria Vuorilehto^b ; ^f ; Liisa Keltikangas-Jä ; rvinen^a ; Erkki Isometsä ; ^b ; ^f ; ^g
• 关键词：Personality ; Major depressive disorder ; Bipolar disorder ; Mood disorders ; Longitudinal data ; Prevention
• 刊名：Journal of Affective Disorders
• 出版年：April, 2014
• 年：2014
• 卷：158
• 期：Complete
• 页码：139-147
• 全文大小：512 K

文摘

Background

Personality traits are associated with depressive symptoms and psychiatric disorders. Evidence for their value in predicting accumulation of future dysphoric episodes or clinical depression in long-term follow-up is limited, however.

Methods

Within a 15-year longitudinal study of a general-population cohort (N=751), depressive symptoms were measured at four time points using Beck壮s Depression Inventory. In addition, 93 primary care patients with DSM-IV depressive disorders and 151 with bipolar disorder, diagnosed with SCID-I/P interviews, were followed for five and 1.5 years with life-chart methodology, respectively. Generalized linear regression models were used to predict future number of dysphoric episodes and total duration of major depressive episodes. Baseline personality was measured by the Temperament and Character Inventory (TCI).

Results

In the general-population sample, one s.d. lower Self-directedness predicted 7.6-fold number of future dysphoric episodes; for comparison, one s.d. higher baseline depressive symptoms increased the episode rate 4.5-fold. High Harm-avoidance and low Cooperativeness also implied elevated dysphoria rates. Generally, personality traits were poor predictors of depression for specific time points, and in clinical populations. Low Persistence predicted 7.5% of the variance in the future accumulated depression in bipolar patients, however.

Limitations

Degree of recall bias in life charts, limitations of statistical power in the clinical samples, and 21-79% sample attrition (corrective imputations were performed).

Conclusion

TCI predicts future burden of dysphoric episodes in the general population, but is a weak predictor of depression outcome in heterogeneous clinical samples. Measures of personality appear more useful in detecting risk for depression than in clinical prediction.