Personality and differential treatment response in major depression: a randomized controlled trial comparing cognitive-behavioural therapy and pharmacotherapy.
OBJECTIVE
Effective treatments for major depressive disorder exist, yet some patients fail to respond, or achieve only partial response. One approach to optimizing treatment success is to identify which patients are more likely to respond best to which treatments. The objective of this investigation was to determine if patient personality characteristics are predictive of response to either cognitive-behavioural therapy (CBT) or pharmacotherapy (PHT).


METHODS
Depressed patients completed the Revised NEO Personality Inventory, which measures the higher-order domain and lower-order facet traits of the Five-Factor Model of Personality, and were randomized to receive either CBT or PHT.


RESULTS
Four personality traits--the higher-order domain neuroticism and 3 lower-order facet traits: trust, straightforwardness, and tendermindedness--were able to distinguish a differential response rate to CBT, compared with PHT.


CONCLUSIONS
The assessment of patient dimensional personality traits can assist in the selection and optimization of treatment response for depressed patients.
Bagby
R Michael
RM
Centre for Addiction and Mental Health, Toronto, Ontario. michael_bagby@camh.net
Quilty
Lena C
LC
Segal
Zindel V
ZV
McBride
Carolina C
CC
Kennedy
Sidney H
SH
Costa
Paul T
PT
D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000706:statistics & numerical data*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004358:Drug Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010551:Personality; D010552:Personality Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome