Association of Five-Factor Model Personality Domains and Facets with Presence, Onset, and Treatment Outcomes of Major Depression in Older Adults

Abstract

Objectives To assess the relationship of multiple domains and facets of the five factor model of personality with presence, onset, and severity of late life depression. Design Cross-sectional analysis of depression status, and age of onset. Retrospective analysis of baseline severity. Longitudinal analysis of severity after 3 and 12 months of psychiatric treatment. Setting: Private university-affiliated medical center in the Southeastern US. Participants One hundred twelve psychiatric patients with a current episode of unipolar major depression, and 104 nondepressed comparison subjects, ages 60 years and older (mean = 70, SD = 6). Measurements Revised NEO Personality Inventory, Diagnostic Interview Schedule, Montgomery-Åsberg Depression Rating Scale. Results Binary logistic regression found that depression was related to higher neuroticism (and all its facets), and to lower extraversion (and facets of assertiveness, activity, and positive emotionality), and conscientiousness (and facets of competence, order, dutifulness, and self-discipline). Multinomial logistic regression found some of these relationships held only for depression with onset before age 50 (hostility, self-consciousness, extraversion, assertiveness, positive emotions, order, and dutifulness). Linear regression found that personality was unrelated to depression severity at the beginning of treatment, but improvement after 3 months was related to lower neuroticism (and facets depressiveness and stress-vulnerability) and higher warmth and competence. Improvement after 12 months was related to lower neuroticism, depressiveness, and stress-vulnerability. Conclusions Specific personality facets are related with depression and treatment outcomes. Screening for certain personality traits at the start of treatment may help identify patients at risk of worse response to treatment after 3 months.

Neuroticism Traits Selectively Impact Long Term Illness Course and Cognitive Decline in Late-Life Depression

“…The present findings replicate and extend existing evidence for the impact of neuroticism, and VS specifically, on both treatment response and cognitive decline in LLD (18, 19). The current findings demonstrate a clinically meaningful 10-point difference in global cognition between high and low VS LLD subjects at 10 years.…”

“…Our preliminary evidence indicated high total neuroticism and the VS trait were the only neuroticism scores associated with both a worse one-year antidepressant treatment response and a two-year decline in global cognitive functioning in LLD (18, 19). Elsewhere, increased VS and anxiety were the only neuroticism traits associated with global cognitive decline in non-depressed older adults followed over three years (11).…”

“…We therefore hypothesized that LLD patients with high VS would be associated with worse illness course and cognitive decline over time. We extended our preliminary investigations into the association between neuroticism and one-year illness course (19) and two- year global cognitive functioning (18) by including participants followed upwards of 10 years. We also measured multiple cognitive domains as opposed to just global functioning and investigated the association between long-term outcomes and all six neuroticism traits in order to understand individual differences within neuroticism that influence cognition and treatment.…”

Personality Factors and Suicide Risk in a Representative Sample of the German General Population

“…It aims to empirically describe personality along five major dimensions, namely neuroticism, extraversion, openness, agreeableness, and conscientiousness [4,5]. These five personality dimensions show clear heritable characteristics [6,7] and have been shown to be associated with different psychiatric disorders such as anxiety, depressive, substance use, and personality disorders [8,9,10,11]. …”

Neuroticism in Remitted Major Depression: Elevated with Early Onset but Not Late Onset of Depression

“…Three such studies [20,21,22] reported a greater increase (relative to controls) of neuroticism in EOD than in LOD, and three [23,24,25] found equal increases of neuroticism in EOD and LOD. Two of the studies employed a methodologically strong community-based longitudinal prospective design with personality measures predicting depressive episodes 3-5 years [20] and 10 years [22] later.…”