The effect of temperament and character on response to selective serotonin reuptake inhibitors in panic disorder.
OBJECTIVE
In this prospective study, temperament and character were evaluated in patients with panic disorder (PD), before 1 year of medication therapy, to verify whether these factors influenced the outcome of treatment.


METHODS
Seventy-one PD patients were evaluated with the SCID-IV, the Temperament and Character Inventory (TCI), the SCL-90, the Ham-A and the Ham-D. Patients were treated with pharmacotherapy and were evaluated monthly over 1 year.


RESULTS
Before treatment, non-remitted patients showed higher levels of harm avoidance (HA) and lower levels of persistence (P), self-directedness (SD) and cooperativeness (C), whereas remitted patients showed only higher levels of HA. After controlling the effect of the confounding variables, the likelihood to achieve remission was positively related to SD score (OR = 1.12; P = 0.002), particularly 'self-acceptance' SD dimension (OR = 1.30; P = 0.02).


CONCLUSIONS
Our data suggest that in PD: i) the evaluation of personality, using the Cloninger's model, confirms the presence of personality pathology as one predictor of non-response to treatment; ii) in patients with low SD a combination of medication and cognitive-behaviour therapy should be the most effective treatment.
Marchesi
C
C
Department of Neuroscience, Psychiatric Division, University of Parma, Parma, Italy. carlo.marchesi@unipr.it
Cantoni
A
A
Fontò
S
S
Giannelli
M R
MR
Maggini
C
C
D000328:Adult; D002605:Character; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D040261:Harm Reduction; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D016584:Panic Disorder / Q000188:drug therapy* / Q000523:psychology; D010349:Patient Compliance; D010554:Personality Disorders / Q000150:complications / Q000523:psychology; D010555:Personality Inventory; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013694:Temperament
D017367:Selective Serotonin Reuptake Inhibitors