title: Temperament and character traits predict future burden of depression.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Degree of recall bias in life charts, limitations of statistical power in the clinical samples, and 21-79% sample attrition (corrective imputations were performed).
  
  
  CONCLUSIONS
  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.
authors.affiliation: IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland. Electronic address: tom.rosenstrom@helsinki.fi.
authors.forename: Tom
authors.initials: T
authors.lastname: Rosenström
authors.affiliation: 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.
authors.forename: Pekka
authors.initials: P
authors.lastname: Jylhä
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA.
authors.forename: C
authors.initials: C
authors.lastname: Robert Cloninger
authors.affiliation: IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland; Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland.
authors.forename: Mirka
authors.initials: M
authors.lastname: Hintsanen
authors.affiliation: IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland; National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Marko
authors.initials: M
authors.lastname: Elovainio
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute of Health and Welfare, Helsinki, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Outi
authors.initials: O
authors.lastname: Mantere
authors.affiliation: IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland.
authors.forename: Laura
authors.initials: L
authors.lastname: Pulkki-Råback
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute of Health and Welfare, Helsinki, Finland.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Riihimäki
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute of Health and Welfare, Helsinki, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Maria
authors.initials: M
authors.lastname: Vuorilehto
authors.affiliation: IBS, Unit of Personality, Work and Health Psychology, University of Helsinki, Helsinki, Finland.
authors.forename: Liisa
authors.initials: L
authors.lastname: Keltikangas-Järvinen
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute of Health and Welfare, Helsinki, Finland; Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, Helsinki, Finland; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Erkki
authors.initials: E
authors.lastname: Isometsä
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology; D002605:Character; D003866:Depressive Disorder / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013694:Temperament; D055815:Young Adult
keywords: Bipolar disorder; Longitudinal data; Major depressive disorder; Mood disorders; Personality; Prevention