Scala Mauro, Gori Davide, Roca Pablo, Fabbri Chiara, Arroyo Iturra Rocío, Calvo García Sergio Felipe, Fanelli Giuseppe, Serretti Alessandro
Universidad Europea de Madrid, Faculty of Biomedical and Health Sciences, Campus de Villaviciosa, Calle Tajo s/n, 28670, Villaviciosa de Odón, Madrid, Spain.
School of Medicine, Complutense University of Madrid, Madrid, Spain.
Eur Arch Psychiatry Clin Neurosci. 2025 Nov 12. doi: 10.1007/s00406-025-02127-4.
Personality traits influence symptoms, functioning, and illness trajectory in chronic psychosis. However, their role in early-stage psychosis remains poorly defined, particularly regarding potential differences from healthy controls and their association with clinical outcomes.
We conducted a systematic review and meta-analysis of studies assessing personality domains in early-stage psychosis using validated dimensional instruments. Searches were performed in PubMed/MEDLINE, CINAHL, and Web of Science until March 2025. The meta-analysis included studies using the NEO Five-Factor Inventory (NEO-FFI), with patient scores compared to published normative data. Studies reporting T-scores and those reporting raw scores were analyzed separately. Associations between personality domains and clinical features were narratively synthesized.
Eighteen studies met the inclusion criteria; eight were included in the meta-analysis (n = 1109). Considering studies reporting T-scores, individuals with early-stage psychosis showed higher neuroticism (MD = 27.4, 95% CI [25.0 to 29.9]) and lower extraversion (MD = -6.0, 95% CI [-8.6 to -3.5]) and conscientiousness (MD = -5.5, 95% CI [-7.9 to -3.2]), relative to normative data. Analyses of studies reporting raw scores showed similar effects, though not statistically significant. The same personality domains were consistently associated with symptom severity, treatment adherence, functioning, and service use.
Early-stage psychosis may be characterized by a specific personality profile that modulates clinical presentation. Early personality assessment may guide tailored treatment strategies. Longitudinal studies are needed to clarify their prognostic relevance and potential role in the personalization of treatment.
人格特质会影响慢性精神病的症状、功能及疾病轨迹。然而，它们在早期精神病中的作用仍未明确界定，尤其是与健康对照的潜在差异及其与临床结局的关联。
我们对使用经过验证的维度工具评估早期精神病患者人格领域的研究进行了系统评价和荟萃分析。检索了PubMed/MEDLINE、CINAHL和Web of Science，直至2025年3月。荟萃分析纳入了使用大五人格量表（NEO-FFI）的研究，并将患者得分与已发表的常模数据进行比较。分别分析了报告T分数的研究和报告原始分数的研究。对人格领域与临床特征之间的关联进行了叙述性综合分析。
18项研究符合纳入标准；8项纳入荟萃分析（n = 1109）。考虑报告T分数的研究，与常模数据相比，早期精神病患者表现出更高的神经质（MD = 27.4，95% CI [25.0至29.9]）、更低的外向性（MD = -6.0，95% CI [-8.6至-3.5]）和尽责性（MD = -5.5，95% CI [-7.9至-3.2]）。对报告原始分数的研究分析显示了类似的效果，尽管无统计学意义。相同的人格领域始终与症状严重程度、治疗依从性、功能及服务利用相关。
早期精神病可能具有特定的人格特征，可调节临床表现。早期人格评估可能指导量身定制的治疗策略。需要进行纵向研究以阐明其预后相关性及在治疗个性化中的潜在作用。
