The majority of people who receive antidepressant treatment for major depression (MDD) respond well after the first several months. Of those who don’t, some see symptom relief after trying a few different medications until they find the one that works well for them. However, a small percentage of people with MDD do not respond to antidepressant treatment at all. These treatment-resistant individuals often continue to experience debilitating symptoms of depression, regardless of what treatment approaches they pursue.
Existing research on depression suggests that treatment resistant individuals may have unique personality traits that limit their ability to respond well, but these traits have not been fully explored. To find out what traits may impeded recovery and remission in treatment resistant depression, Michio Takahashi of the Department of Psychiatry at Teikyo University Chiba Medical Center in Japan recently led a study examining the personality traits of 31 MDD participants in remission, 35 treatment resistant participants, and 174 participants with no history of MDD, who served as controls.
Takahashi used the Temperament and Character Inventory (TCI) to assess the traits and found that those with treatment-resistant MDD had high levels of harm avoidance and low levels of reward dependence, cooperativeness, and self-directedness. Harm avoidance and low reward dependence are common traits of depression. Because the nonremitted treatment-resistant participants were still depressed, it makes sense that they were still experiencing these symptoms.
But how these traits impact treatment outcomes is still unclear and should be further examined in future work. Takahashi also discovered that although the participants in remission still had higher levels of harm avoidance than the controls, all of the other personality traits measured by the TCI were equal to those of controls, showing that for these individuals, antidepressant treatment appeared to help with symptoms like reward dependence, cooperation, and self-directedness. Takahashi added, “In conclusion, treatment-resistant patients with MDD demonstrated high scores for harm avoidance, and low scores for reward dependence, self-directedness, and cooperativeness, using the TCI.”
Takahashi, M., Shirayama, Y., Muneoka, K., Suzuki, M., Sato, K., et al. (2013). Personality traits as risk factors for treatment-resistant depression. PLoS ONE 8(5): e63756. doi:10.1371/journal.pone.0063756
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