| ObjectivePrediction of antidepressant treatment outcome brings about significant consequences. The aim of this study is to explore the personality traits of depressive patients and the differences in personality profile between depressive patients and healthy control subjects, assess the impact of personality on treatment outcome and determine whether any of the personality characteristics can predict the outcome of antidepressant treatment.MethodsIn this study, demographic data including gender, age, level of education, occupation and so on were collected for randomly selected 72 patients with depressive disorder and 67 healthy controls. The gender and age of the healthy controls were matched to the patients. All subjects completed the Revised NEO Personality Inventory (NEO-PI-R), which was a self-report questionnaire designed to assess the personality traits. In this questionnaire, the scores for 5 higher-order personality dimensions-Neuroticism, Extraversion, Openness, Agreeableness and Conscientiousness with six lower-order facet traits under each domain were tabulated. Past studies had shown that dimension and facet traits in this questionnaire could be validly and reliably assessed in psychiatric patients. The patients were treated with escitalopram 10mg/d for 8 weeks. Clinical Global Impression (CGI) and the Hamilton Depression Scale (HAMD), the most widely used measure of depression severity in clinical trials, was administrated to assess severity of depression before and after treatment. Severity of anxiety was assessed by Hamilton Anxiety Scale (HAMA). The results were input into a computer after being collected and arranged. All available data were analyzed by SPSS 15.0. The analysis methods included descriptive analysis, one-way analysis of variance, Spearman rank correlation analysis and stepwise regression analysis.Results1. The patients with depression had a significantly different personality profile compared with healthy controls at baseline (P<0.05), except N5, E2, E5,01, A1, A2, A4, A5, C3. The results of one-way analysis of variance for individual domains showed that the depressive patients had significantly higher scores for Neuroticism(F=32.372, P<0.001) and lower scores for Extraversion(F=37.841, P< 0.001), Openness(F=36.019 P< 0.001), Agreeableness(F=37.813, P< 0.05), Conscientiousness(F=34.241, P< 0.001) at baseline in comparison with controls.2. Spearman rank correlation analysis showed a positive correlation between N1 and HAMD total scores at baseline(r=0.415, P<0.05) and O4, A1 were negatively correlated to the total scores of HAMD(r=-0.479, P<0.05; r=-0.455, P <0.05). There was a significantly positive correlation between N, N1, N2, N3 and the total scores of HAMA(r=0.528, P<0.01; r=0.477, P<0.05; r=0.423, P<0.05; r=0.560,P<0.01),and E2,E6,A1 were negatively correlated to the total scores of HAMA(r=-0.505, P<0.05;r=-0.493, P<0.05; r=-0.556, P<0.01).3. Stepwise regression analysis showed that N1, N3, C and C3 were strongly associated with score reduced rates of HAMD by the end of the eighth week and they were the main factors influencing clinical outcome. Patients with higher scores of N1, N3 and lower scores of C, C3 displayed bad outcome.Conclusion1. There are significant differences of personality traits between depressive patients and healthy control subjects. The patients have higher Neuroticism score and lower Extraversion, Openness, Agreeableness, Conscientiousness scores. People with high level of Neuroticism may be prone to depressive disorder. 2. N1, O4, A1 are significantly correlated with the severity of depression as measured by HAMD scale before treatment. With higher Anxiety score and lower Actions and Trust score, the depression is more severe. And the severity of anxiety is associated with high Neuroticism score.3. Personality traits may predict clinical outcome in depressive patients, especially N1 and N3 are stronger predictors of treatment outcome and they are related to the quality of termination of pharmacotherapy. |
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