Treatment-Resistant Depression Has Unique Personality

The majority of individuals who experience depression respond to treatment within a few months. Whether the treatment involves antidepressant medication, therapy, or a combination of both, many see significant symptoms reduction as a result. However, there is a small percentage of individuals who are resistant to treatment. They do not respond to antidepressants or therapy, and rarely go on to see full remission or reduction of symptoms.

Michio Takahashi and colleagues from the Department of Psychiatry at Teikyo University Chiba Medical Center in Japan previously conducted research that revealed treatment-resistant depression is associated with low cooperativeness and low levels of reward dependence. In an effort to examine other personality traits and biases that could be associated with treatment resistant depression, Takahashi recently conducted a new study using the NEO Personality Inventory scale. This scale considers five specific factors of personality including conscientiousness, openness, agreeableness, extraversion, and neuroticism. For the study, Takahashi administered the NEO to 35 participants with treatment-resistant depression, 27 participants who were in remission from depression, and 66 nonclinical control participants.

The results revealed that the participants who had resistant symptoms of depression had higher levels of neuroticism when compared to controls and remitted participants. Further, these same participants had very low levels of extraversion and conscientiousness, although agreeableness levels were relatively equal to those in remission or those with no depression. The most significant finding was based on the personality trait of openness. In fact, treatment resistant participants had significantly low levels of openness when compared to the other participants.

Takahashi said that high levels of openness are related to positive, flexible thinking, which allows individuals to accept and develop new, productive coping strategies. A lack of openness can promote rigid thinking, negative affect, denial, pessimism, and disengagement, all behaviors and actions that can stall the therapeutic process and can perpetuate depression. “Our study highlights low openness on the NEO, as a risk mediator in treatment-resistant depression,” said Takahashi, adding, “This newly identified trait should be included as a risk factor in treatment-resistant depression.”

Takahashi, M., Shirayama, Y., Muneoka, K., Suzuki, M., Sato, K., et al. (2013). Low openness on the revised NEO personality inventory as a risk factor for treatment-resistant depression. PLoS ONE 8(9): e71964. doi:10.1371/journal.pone.0071964

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  • Abe


    September 19th, 2013 at 3:45 AM

    I would hate to think that in addition to being depressed that I was so rigid in my manner of thinking that I had cloed off my mind to any possibility to treatment working very well on me. Just like with almost anything you have to be able to keep an open mind in order to get the ebst results. If you automatically close your mind to the possibilities than you are very much limiting yourself and your opportunities for improvement and in this case, recovery.

  • Pierce


    September 19th, 2013 at 12:19 PM

    Is it the depression or is it the person?
    i tend to think that it has to be the patient holding back and not letting something work, because depression, even though it might differ in severity, seems like it is just still depression. That the person determines what will work and what won’t.

  • happy


    September 20th, 2013 at 3:56 AM

    My initial thoughts when reading this would be that there is something in this type of person’s past that would inhibit them. What has happened to them before that makes them less open? What have they expereinced that would leave them perhaps feeling distrustful of the process and unwilling to see the healing through?

    I am sure that any therapist would work through all of this with a patient but as just an everyday Joe this would immediately be my first thoughts about where to start.

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