Cloninger temperament traits (novelty seeking, harm avoidance, reward dependence, and persistence) may predict outcome in patients treated for depression, according to a study recently published in the Journal of Affective Disorders.
Investigators performed a naturalistic longitudinal chart review to examine the effects of temperament in patients diagnosed with depression. The study included individuals with a diagnosis of any depressive disorder with or without comorbid anxiety disorder, panic disorder, generalized anxiety disorder, or mixed anxiety-depressive disorder.
Individuals with bipolar disorder, obsessive-compulsive disorder, posttraumatic stress disorder, severe personality disorder, substance use disorders (except tobacco), and psychotic and organic disorders were excluded from this study. All diagnoses were determined by ICD-10 diagnostic codes.
Overall, 200 outpatients participated in the study. Their temperament was assessed based on the Tridimensional Personality Questionnaire (TPQ). Depression in patients was blindly rated based on the improved Clinical Global Impression-Severity scale for depression (iCGI-S) at baseline, 6 weeks, 3 months, and 6 months. Investigators determined therapeutic response by a reduction of greater than 50% in the last iCGI-S score and remission by a final iCGI-S score of 0.
Remission in participants was independently and directly related to the length of follow-up and inversely related to baseline iCGI-S score and harm avoidance. Persistence temperament had a complex V-shape relationship with remission. For the subset of patients with more severe cases of depression (n=118) and high harm avoidance scores, a more favorable outcome was related to higher reward dependence and the non-smoking condition.
A limitation of this study is that the sample may not be representative of the overall population, and the results may not be generalizable.
The study suggests that harm avoidance temperament is linked to worse outcomes in a 6-month follow-up for patients with varying severity of depression. Persistence temperament exhibits a complex relationship with outcome. Further research is necessary to better understand this relationship.
Gurpegui D, Ortuño F, Gurpegui M. Temperament traits and remission of depression: a naturalistic six-month longitudinal study. J Affect Disord. 2019; 243:494-502.