Cohen Nicole L, Ross Erin C, Bagby R Michael, Farvolden Peter, Kennedy Sidney H
Department of Psychiatry, University Health Network, Toronto, Ontario.
Can J Psychiatry. 2004 Feb;49(2):106-13. doi: 10.1177/070674370404900205.
Medication noncompliance is a significant problem for effective pharmacologic treatment of major depressive disorder (MDD). Attempts to explore predictors of compliance have primarily focused on demographic characteristics; for the most part, these have been shown to be unrelated to compliance. Conversely, the relation between personality characteristics and compliance has been relatively understudied. The primary purpose of this study was to explore the relation between personality characteristics and compliance with antidepressant medication in patients with major depressive disorder (MDD).
Over 14 weeks, we evaluated a sample of outpatients (n = 65) who were receiving antidepressant treatment. We monitored compliance electronically, using the Medication Event Monitoring System. We assessed personality characteristics with the NEO Five-Factor Inventory-Revised. We also assessed depression severity and the frequency and severity of side effects.
Extraversion was a significant negative predictor of compliance. This was largely explained by the relation between compliance and the Activity facet within Extraversion. We also found a negative relation between the Feelings facet and compliance, while the Modesty facet was a significant positive predictor of compliance with antidepressant medication. Neither severity of depression nor side effects predicted compliance.
These results suggest that correlates of personality are important, although frequently ignored, predictors of compliance with antidepressant medication. Identifying predictors of medication compliance may help in the development of individualized treatment regimens and lead to improved therapeutic outcome in the treatment of MDD.
药物治疗依从性不佳是重度抑郁症（MDD）有效药物治疗的一个重大问题。探索依从性预测因素的尝试主要集中在人口统计学特征上；在很大程度上，这些特征已被证明与依从性无关。相反，人格特征与依从性之间的关系相对较少受到研究。本研究的主要目的是探讨重度抑郁症（MDD）患者的人格特征与抗抑郁药物依从性之间的关系。
在14周的时间里，我们评估了一组接受抗抑郁治疗的门诊患者（n = 65）。我们使用药物事件监测系统以电子方式监测依从性。我们用修订后的NEO五因素问卷评估人格特征。我们还评估了抑郁严重程度以及副作用的频率和严重程度。
外向性是依从性的一个显著负向预测因素。这在很大程度上可以通过依从性与外向性中的活动方面之间的关系来解释。我们还发现情感方面与依从性之间存在负相关，而谦逊方面是抗抑郁药物依从性的一个显著正向预测因素。抑郁严重程度和副作用均不能预测依从性。
这些结果表明，人格相关因素是抗抑郁药物依从性的重要预测因素，尽管它们经常被忽视。识别药物依从性的预测因素可能有助于制定个体化治疗方案，并改善重度抑郁症治疗的疗效。
