Quilty Lena C, De Fruyt Filip, Rolland Jean-Pierre, Kennedy Sidney H, Rouillon Pr Frédéric, Bagby R Michael
Clinical Research Department, Centre for Addiction and Mental Health, Canada.
J Affect Disord. 2008 Jun;108(3):241-50. doi: 10.1016/j.jad.2007.10.022. Epub 2007 Dec 11.
This study investigated the association between dimensional personality traits from the Five-Factor Model (FFM) and treatment outcome in patients with Major Depressive Disorder (MDD).
Six hundred forty-nine outpatients with MDD participated in a randomised double-blind longitudinal study for 6 months. Patients received a combination of medication and psychotherapy; they were randomised to medication condition (tianeptine or fluoxetine), and non-randomly assigned to psychotherapy condition (supportive, cognitive-behavioural, or psychodynamic). The Montgomery Asberg Depression Rating Scale was used to assess depression severity. The Système de Description en Cinq Dimensions was used to assess the personality domains of the FFM.
Group comparisons revealed that patients who responded to both medication and psychotherapy had lower Neuroticism (t=4.22, p<.01), and higher Extraversion (t=4.01, p<.01) and Openness to Experience scores (t=3.57, p<.01) compared to non-responders. Regression analyses, which controlled for shared variance among the five personality domains, indicated that Neuroticism (chi(2)=4.06, p=.04) and Conscientiousness (chi(2)=8.98, p<.01) were significantly and uniquely associated with response. The two-way interactions between NeuroticismxExtraversion (chi(2)=4.49, p=.03) and ExtraversionxConscientiousness (chi(2)=5.91, p=.01) were also associated with response. These results were mostly replicated across the treatment-completer and intent-to-treat samples.
Dimensional personality traits predict response for individuals with MDD.
This study did not examine facet-level traits, patient pre-morbid personality and functioning, and additional patient characteristics. Results may not be generalizable to severely depressed or treatment refractory patients.
本研究调查了大五人格模型（FFM）中的维度人格特质与重度抑郁症（MDD）患者治疗结果之间的关联。
649名MDD门诊患者参加了一项为期6个月的随机双盲纵向研究。患者接受药物治疗和心理治疗相结合的方案；他们被随机分配到药物治疗组（噻奈普汀或氟西汀），并非随机分配到心理治疗组（支持性、认知行为或心理动力学）。使用蒙哥马利-阿斯伯格抑郁评定量表评估抑郁严重程度。使用五维度描述系统评估FFM的人格领域。
组间比较显示，与无反应者相比，对药物治疗和心理治疗均有反应的患者神经质得分较低（t = 4.22，p <.01），外向性得分较高（t = 4.01，p <.01），经验开放性得分较高（t = 3.57，p <.01）。回归分析控制了五个个性领域之间的共同方差，结果表明神经质（χ² = 4.06，p =.04）和尽责性（χ² = 8.98，p <.01）与反应显著且独特相关。神经质×外向性（χ² = 4.49，p =.03）和外向性×尽责性（χ² = 5.91，p =.01）之间的双向交互作用也与反应相关。这些结果在治疗完成者和意向性治疗样本中大多得到了重复。
维度人格特质可预测MDD患者的反应。
本研究未考察层面特质、患者病前人格和功能以及其他患者特征。结果可能不适用于重度抑郁或治疗难治性患者。
