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Dimensions of temperament and character as predictors of antidepressant discontinuation, response and adverse reactions during treatment with nortriptyline and escitalopram.
Köhler-Forsberg, Ole; Keers, Robert; Uher, Rudolf; Hauser, Joanna; Maier, Wolfgang; Rietschel, Marcella; McGuffin, Peter; Farmer, Anne E; Aitchison, Katherine J; Mors, Ole.
Afiliação
  • Köhler-Forsberg O; Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.
  • Keers R; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  • Uher R; Department of Biological and Experimental Psychology, Queen Mary University of London, Mile End, London, UK.
  • Hauser J; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Maier W; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
  • Rietschel M; Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
  • McGuffin P; Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland.
  • Farmer AE; Department of Psychiatry, University of Bonn, Bonn, Germany.
  • Aitchison KJ; Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
  • Mors O; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Psychol Med ; 53(6): 2522-2530, 2023 04.
Article em En | MEDLINE | ID: mdl-34763734
BACKGROUND: Personality traits may predict antidepressant discontinuation and response. However, previous studies were rather small, only explored a few personality traits and did not include adverse drug effects nor the interdependency between antidepressant discontinuation patterns and response. METHODS: GENDEP included 589 patients with unipolar moderate-severe depression treated with escitalopram or nortriptyline for 12 weeks. Seven personality dimensions were measured using the self-reported 240-item Temperament and Character Inventory-Revised (TCI-R). We applied Cox proportional models to study discontinuation patterns, logistic and linear regression to investigate response and remission after 8 and 12 weeks, and mixed-effects linear models regarding time-varying treatment response and adverse drug reactions. RESULTS: Low harm avoidance, low cooperativeness, high self-transcendence and high novelty seeking were associated with higher risks for antidepressant discontinuation, independent of depressed mood, adverse drug reactions, drug, sex and age. Regression analyses showed that higher novelty seeking and cooperativeness scores were associated with a greater likelihood of response and remission after 8 and 12 weeks, respectively, but we found no correlations with response in the mixed-effects models. Only high harm avoidance was associated with more self-reported adverse effects. CONCLUSIONS: This study, representing the largest investigation between several personality traits and response to two different antidepressants, suggests that correlations between personality traits and antidepressant treatment response may be confounded by differential rates of discontinuation. Future trials on personality in the treatment of depression need to consider this interdependency and study whether interventions aiming at improving compliance for some personality types may improve response to antidepressants.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Temperamento / Transtorno Depressivo Maior Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Psychol Med Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Dinamarca

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Temperamento / Transtorno Depressivo Maior Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: Psychol Med Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Dinamarca