Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T06:54:32.361Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  04 December 2017

David C. Steffens ,
Rong Wu ,
James J. Grady  and
Kevin J. Manning
David C. Steffens*
Affiliation:
Departments of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
Rong Wu
Affiliation:
Biostatistics Center, Connecticut Institute for Clinical and Translational Science, University of Connecticut School of Medicine, Farmington, Connecticut, USA
James J. Grady
Affiliation:
Biostatistics Center, Connecticut Institute for Clinical and Translational Science, University of Connecticut School of Medicine, Farmington, Connecticut, USA Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut, USA
Kevin J. Manning
Affiliation:
Departments of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
*
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.
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

depressionneuroticismelderlytreatment
Type
Brief Report
Information
International Psychogeriatrics , Volume 30 , Issue 7: Issue Theme: Benzodiazepines and Hypnotics , July 2018 , pp. 1069 - 1074
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bock, C. et al. (2010). The influence of comorbid personality disorder and neuroticism on treatment outcome in first episode depression. Psychopathology, 43, 197–204.Google Scholar
Canuto, A. et al. (2009). Personality traits influence clinical outcome in day hospital-treated elderly depressed patients. American Journal of Geriatric Psychiatry, 17, 335–343.Google Scholar
Costa, P. T. and McCrae, R. R. (1985). The NEO Personality Inventory Manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
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.Google Scholar
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, 157–163.Google Scholar
Hirschfeld, R. M. et al. (1989). Premorbid personality assessments of first onset of major depression. Archives of General Psychiatry, 46, 345–350.Google Scholar
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, 631–636.Google Scholar
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, 38–45.Google Scholar
Segal, Z. V. et al. (2006). Cognitive reactivity to sad mood provocation and the prediction of depressive relapse. Archives of General Psychiatry, 63, 749–755.Google Scholar
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, 277–285.Google Scholar
Steffens, D. C. et al. (2013). Clinical outcomes of older depressed patients with and without comorbid neuroticism. International Psychogeriatrics, 25, 1985–1990.Google Scholar
Steffens, D. C. et al. (2015). Methodology and preliminary results from the neurobiology of late-life depression study. International Psychogeriatrics, 27, 1987–1997.Google Scholar
Steunenberg, B. et al. (2007). Mastery and neuroticism predict recovery of depression in later life. Amercian Journal of Geriatric Psychiatry, 15, 234–242.Google Scholar