Temperament and character profiles associated with depression and treatment response in patients with or without comorbid substance abuse

Temperament and character profiles are associated with depression outcome in psychiatric secondary care patients with harmful drinking

“…Poorer outcome of depression was predicted by low Reward Dependence in the linear mixed effects model adjusted with AUP, gender, AUP x gender and AUP x time. In contrast to some earlier studies our present and earlier findings suggest that Reward Dependence is associated with depression treatment outcome [4,16,26]. This difference in results could be explained by differences in patient samples, as patients with…”

“…SUDs have been excluded in those earlier studies but not in this present one [4,16,26]. Our earlier and present results suggest that low RD predicts poorer outcome of depression particularly in depressed 10 patients with comorbid alcohol use problems.…”

“…In light of earlier evidence we hypothesize that high HA and low SD and harmful alcohol use together explain poorer depression treatment outcome (measured as MADRS scores) [4,5,25]. As harmful alcohol use had a modifying effect on both temperament and character dimensions during acute illness, we hypothesize that RD together with alcohol use is also associated with outcome of depression in the long-term follow-up (from 6 weeks to 6 and 24 months) [16]. High NS has been associated with more severe SUDs, and therefore we also hypothesized that this temperament trait might modify treatment outcome together with harmful alcohol use in depression [6].…”

“…High RD could be protective against depression in general population, but no associations have been reported with outcome of depression in clinically depressed patients [4,[11][12][13][14][15]. Our earlier study of this patient sample suggested that RD is associated with depression treatment outcome in patients with alcohol use problems as change in RD was strongly associated with acute treatment response (0-6 weeks) to depression when alcohol use was taken into account [16]. High NS is a trait indisputably associated with risk of substance use disorders, more severe symptomatology and poorer outcome in SUD patients, and apparently experienced at a higher level in patients with dual diagnosis (concurrent SUD and mental illness) than in depressed patients [3,6,[17][18][19][20].…”

“…Of these, 82% had either an SSRI or SNRI as a primary antidepressant. Adherence to antidepressants was monitored during the first six weeks of the study using a paper and pencil diary (for more information see [16]). [36,37].…”