Rosenström Tom, Jylhä Pekka, Robert Cloninger C, Hintsanen Mirka, Elovainio Marko, Mantere Outi, Pulkki-Råback Laura, Riihimäki Kirsi, Vuorilehto Maria, Keltikangas-Järvinen Liisa, Isometsä Erkki
IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
Department of Mental Health and Substance Abuse Services, National Institute of Health and Welfare, Helsinki, Finland; Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland.
J Affect Disord. 2014 Apr;158:139-47. doi: 10.1016/j.jad.2014.01.017. Epub 2014 Feb 11.
Personality traits are associated with depressive symptoms and psychiatric disorders. Evidence for their value in predicting accumulation of future dysphoric episodes or clinical depression in long-term follow-up is limited, however.
Within a 15-year longitudinal study of a general-population cohort (N=751), depressive symptoms were measured at four time points using Beck׳s Depression Inventory. In addition, 93 primary care patients with DSM-IV depressive disorders and 151 with bipolar disorder, diagnosed with SCID-I/P interviews, were followed for five and 1.5 years with life-chart methodology, respectively. Generalized linear regression models were used to predict future number of dysphoric episodes and total duration of major depressive episodes. Baseline personality was measured by the Temperament and Character Inventory (TCI).
In the general-population sample, one s.d. lower Self-directedness predicted 7.6-fold number of future dysphoric episodes; for comparison, one s.d. higher baseline depressive symptoms increased the episode rate 4.5-fold. High Harm-avoidance and low Cooperativeness also implied elevated dysphoria rates. Generally, personality traits were poor predictors of depression for specific time points, and in clinical populations. Low Persistence predicted 7.5% of the variance in the future accumulated depression in bipolar patients, however.
Degree of recall bias in life charts, limitations of statistical power in the clinical samples, and 21-79% sample attrition (corrective imputations were performed).
TCI predicts future burden of dysphoric episodes in the general population, but is a weak predictor of depression outcome in heterogeneous clinical samples. Measures of personality appear more useful in detecting risk for depression than in clinical prediction.
人格特质与抑郁症状及精神疾病相关。然而，在长期随访中，其预测未来烦躁发作或临床抑郁症累积情况的价值证据有限。
在一项针对普通人群队列（N = 751）的15年纵向研究中，使用贝克抑郁量表在四个时间点测量抑郁症状。此外，对93例经DSM-IV诊断为抑郁症的初级保健患者和151例经SCID-I/P访谈诊断为双相情感障碍的患者，分别采用生活图表法进行了5年和1.5年的随访。使用广义线性回归模型预测未来烦躁发作的次数和重度抑郁发作的总持续时间。通过气质与性格问卷（TCI）测量基线人格。
在普通人群样本中，自我导向性得分每降低一个标准差，预测未来烦躁发作次数增加7.6倍；相比之下，基线抑郁症状得分每升高一个标准差，发作率增加4.5倍。高回避伤害性和低合作性也意味着烦躁不安率升高。一般来说，人格特质对特定时间点及临床人群中的抑郁症预测能力较差。然而，低坚持性预测了双相情感障碍患者未来累积抑郁情况中7.5%的方差。
生活图表中的回忆偏倚程度、临床样本中统计效力的局限性以及21 - 79%的样本流失（进行了校正性插补）。
TCI可预测普通人群未来烦躁发作的负担，但在异质性临床样本中对抑郁结局的预测能力较弱。人格测量在检测抑郁症风险方面似乎比临床预测更有用。
