title: Personality traits as risk factors for treatment-resistant depression.
abstract: BACKGROUND
  The clinical outcome of antidepressant treatment in patients with major depressive disorder (MDD) is thought to be associated with personality traits. A number of studies suggest that depressed patients show high harm avoidance, low self-directedness and cooperativeness, as measured on the Temperament and Character Inventory (TCI). However, the psychology of these patients is not well documented.
  
  
  METHODS
  Psychological evaluation using Cloninger's TCI, was performed on treatment-resistant MDD patients (n = 35), remission MDD patients (n = 31), and age- and gender-matched healthy controls (n = 174).
  
  
  RESULTS
  Treatment-resistant patients demonstrated high scores for harm avoidance, and low scores for reward dependence, self-directedness, and cooperativeness using the TCI, compared with healthy controls and remission patients. Interestingly, patients in remission continued to show significantly high scores for harm avoidance, but not other traits in the TCI compared with controls. Moreover, there was a significant negative correlation between reward dependence and harm avoidance in the treatment-resistant depression cohort, which was absent in the control and remitted depression groups.
  
  
  CONCLUSIONS
  This study suggests that low reward dependence and to a lesser extent, low cooperativeness in the TCI may be risk factors for treatment-resistant depression.
authors.affiliation: Department of Psychiatry, Teikyo University Chiba Medical Center, Ichihara, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Shirayama
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Muneoka
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Suzuki
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
authors.forename: Kenji
authors.initials: K
authors.lastname: Hashimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D002605:Character; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology*; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality / Q000187:drug effects*; D010554:Personality Disorders / Q000523:psychology*; D010555:Personality Inventory; D012307:Risk Factors; D013694:Temperament; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents