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Presence of neuroticism and antidepressant remission rates in late-life depression: results from the Neurobiology of Late-Life Depression (NBOLD) study

  • David C. Steffens (a1), Rong Wu (a2), James J. Grady (a2) (a3) and Kevin J. Manning (a1)
Abstract
ABSTRACT

Neuroticism in older adults is common yet understudied, particularly its effects on depression treatment outcomes. We hypothesized that presence of high neuroticism would be associated with lower 12-week remission rates in older depressed sertraline-treated patients. In this longitudinal cohort study, 43 depressed older adults completed the Revised NEO Personality Inventory (NEO PI-R). A study psychiatrist administered the Montgomery Ǻsberg Depression Rating Scale (MADRS), and the Cumulative Illness Rating Scale (CIRS, a measure of medical burden) at baseline, and the MADRS at each clinical visit. All subjects began open-label sertraline treatment and were followed over 12 weeks with clinically indicated flexible dosing and an option to switch antidepressants. We used regression analyses to examine factors related to 12-week remission of depression (MADRS score < 8) and final MADRS score. We found that higher total neuroticism (odds ratio (OR) = 0.963, 95% confidence interval (CI) = 0.928–1.000) and a neuroticism subscale, stress vulnerability (OR = 0.846, 95% CI = 0.728–0.983), were associated with lower likelihood of remission among both the intention-to-treat group and sertraline completers. Findings remained significant after controlling for baseline MADRS and CIRS score. In conclusion, assessment of personality, particularly features of neuroticism, may be important in management of late-life depression. Future studies should determine if depressed patients high in neuroticism may benefit from psychotherapy focusing on emotional regulation and stress management.

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Corresponding author
Correspondence should be addressed to: David C. Steffens, MD, MHS, Professor and Chair, Department of Psychiatry, UConn Health, 264 Farmington Ave, Farmington, CT 06030-1410, USA. Phone: +860-679-4282; Fax: +860-67-1296. Email: steffens@uchc.edu.
References
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Bock C. et al. (2010). The influence of comorbid personality disorder and neuroticism on treatment outcome in first episode depression. Psychopathology, 43, 197204.
Canuto A. et al. (2009). Personality traits influence clinical outcome in day hospital-treated elderly depressed patients. American Journal of Geriatric Psychiatry, 17, 335343.
Costa P. T. and McCrae R. R. (1985). The NEO Personality Inventory Manual. Odessa, FL: Psychological Assessment Resources.
Costa P. T. and McCrae R. R. (1992). Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) Professional Manual. Odessa, FL: Psychological Assessment Resources.
Fiedorowicz J. G. et al. (2010). Neuroticism but not omega-3 fatty acid levels correlate with early responsiveness to escitalopram. Annals of Clinical Psychiatry, 22, 157163.
Hirschfeld R. M. et al. (1989). Premorbid personality assessments of first onset of major depression. Archives of General Psychiatry, 46, 345350.
Kendler K. S., Kuhn J. and Prescott C. A. (2004). The interrelationship of neuroticism, sex, and stressful life events in the prediction of episodes of major depression. American Journal of Psychiatry, 161, 631636.
Kim S. Y. et al. (2016). Influences of the big five personality traits on the treatment response and longitudinal course of depression in patients with acute coronary syndrome: a randomised controlled trial. Journal of Affective Disorders, 203, 3845.
Segal Z. V. et al. (2006). Cognitive reactivity to sad mood provocation and the prediction of depressive relapse. Archives of General Psychiatry, 63, 749755.
Sheline Y. I. et al. (2010). Support for the vascular depression hypothesis in late-life depression: results of a 2-site, prospective, antidepressant treatment trial. Archives of General Psychiatry, 67, 277285.
Steffens D. C. et al. (2013). Clinical outcomes of older depressed patients with and without comorbid neuroticism. International Psychogeriatrics, 25, 19851990.
Steffens D. C. et al. (2015). Methodology and preliminary results from the neurobiology of late-life depression study. International Psychogeriatrics, 27, 19871997.
Steunenberg B. et al. (2007). Mastery and neuroticism predict recovery of depression in later life. Amercian Journal of Geriatric Psychiatry, 15, 234242.
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International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
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