title: A meta-analysis of temperament and character dimensions in patients with mood disorders: Comparison to healthy controls and unaffected siblings.
abstract: BACKGROUND
  Cloninger's psychobiological model of personality has been extensively applied to subjects affected by mood disorders (MOOD). However, most studies are widely heterogeneous in terms of sample size, methods of assessment, and selection of participants.
  
  
  METHODS
  We conducted a systematic review of literature and a random effects meta-analysis of studies comparing at least two of the following groups: (a) adults with a primary MOOD diagnosis (Bipolar Disorder (BP) or major depressive disorder (MDD)), (b) their unaffected siblings (SIB) or (c) healthy subjects (HS), and reporting quantitative results from the Tridimensional Personality Questionnaire (TPQ) or the Temperament and Character Inventory (TCI). Subgroup, sensitivity and meta-regression analyses were also conducted.
  
  
  RESULTS
  High Harm Avoidance and low Self-Directedness were consistently associated with MOOD and SIB samples. BP was characterized by higher scores in Novelty Seeking and Self-Transcendence than HS, SIB and MDD. Age seemed to have a negative effect on Novelty Seeking and a positive effect on Harm Avoidance, Cooperativeness and Self-Transcendence. An euthymic mood state was associated with reduced Harm Avoidance, but increased Reward Dependence, Self-Directedness and Cooperativeness.
  
  
  CONCLUSIONS
  The quality of the included studies varied and was relatively low. Moreover, publication bias and heterogeneity in the distribution of effect sizes may also have limited our results.
  
  
  CONCLUSIONS
  High Harm Avoidance and Low Self-Directedness may be trait markers for MOOD in general, while high Novelty Seeking and high Self-Transcendence may be specific to BP. Future studies are needed to disentangle the state-trait effect of each personality dimension.
authors.affiliation: Department of Biomedical and Neuro-Motor Sciences, University of Bologna, Viale Carlo Pepoli 5, 40123 Bologna, Italy. Electronic address: leozanin8@gmail.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Zaninotto
authors.affiliation: Department of Neuroscience, University of Padova, Padova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Solmi
authors.affiliation: Department of Neuroscience, University of Padova, Padova, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Toffanin
authors.affiliation: Department of Medicine, Geriatric Section, University of Padova, Padova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Washington University School of Medicine, 660 South Euclid Avenue, St Louis, MO 63110, USA.
authors.forename: C Robert
authors.initials: CR
authors.lastname: Cloninger
authors.affiliation: The Zucker Hillside Hospital, Psychiatry Research, North Shore-Glen Oaks, NY, USA; Hofsra North Shore LIJ School of Medicine, Hampstead, NY, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology; D016022:Case-Control Studies; D002605:Character; D003865:Major Depressive Disorder / Q000523:psychology; D040261:Harm Reduction; D006801:Humans; D019964:Mood Disorders / Q000523:psychology*; D010555:Personality Inventory; D012044:Regression Analysis; D035781:Siblings; D013694:Temperament
keywords: Bipolar Disorder; Character; Depression; Mood disorders; State; Temperament; Trait