The role of temperament and character in relapse of major depression

Document Type : Research Paper

Author

Department of Psychology, University of California, Davis, USA. International Joint Laboratory of Behavior and Cognitive Science, Zhengzhou Normal University, China.

10.22038/JFMH.2024.80200.3132

Abstract

Introduction: Major depression is a recurrent and chronic disorder, with many individuals experiencing relapse episodes throughout their lives. Despite extensive research, the factors contributing to recurrence remain unclear. This study explores the relationship between temperament (biological factors), character (social factors), and risk of relapse in depression.
 
Materials and Methods: This descriptive study included 100 patients in remission from major depressive disorder recruited from multiple clinical centers in Tehran, Iran. The patients were selected using a purposive sampling method. Eligibility was determined through a structured clinical interview. Participants completed the Beck Depression Inventory-II (BDI-II) and Cloninger's Temperament and Character Inventory (TCI). We analyzed the data using independent-sample t-tests to explore the relationship between personality components and relapse risk in depression and factor analysis to assess the reliability of the Persian version of the TCI in this clinical sample.
 
Results: Temperament components were not found to be associated with depression relapse. However, self-directedness, a character trait, was significantly linked to relapse. Remitted patients who had experienced a single episode of depression scored higher in self-directedness compared to those with multiple episodes, suggesting that self-directedness may play a crucial role in promoting favorable outcomes.
 
Conclusion: Biological components of personality do not seem to affect outcomes in patients with depression adversely. Conversely, the development of social components of personality, particularly self-directedness, may facilitate improvements in depressive states. These findings have significant implications for both research and clinical practice.

Keywords

References

  1. Chen P, Feng Y, Li XH, Li JX, Wang YY, Zheng WY, et al. Systematic reviews and meta-analyses on major depressive disorder: A bibliometric perspective. Front Psychiatry 2023; 14: 1136125.
  2. Njenga C, Ramanuj PP, de Magalhães FJ, Pincus HA. New and emerging treatments for major depressive disorder. BMJ 2024; 386: e073823.
  3. Böttcher L, Breedvelt JJ, Warren FC, Segal Z, Kuyken W, Bockting CL. Identifying relapse predictors in individual participant data with decision trees. BMC Psychiatry 2023; 23(1): 835-45.
  4. de Zwart PL, Jeronimus BF, de Jonge P. Empirical evidence for definitions of episode, remission, recovery, relapse and recurrence in depression: a systematic review. Epidemiol Psychiatr Sci 2019; 28(5): 544-62.
  5. Touya M, Lawrence DF, Kangethe A, Chrones L, Evangelatos T, Polson M. Incremental burden of relapse in patients with major depressive disorder: a real-world, retrospective cohort study using claims data. BMC Psychiatry 2022; 22(1): 152-61.
  6. Laricchiuta D, Picerni E, Markett S, Reuter M, Montag C. An update on premorbid personality traits and brain recovery: Another aspect of resilience. In: Neurobiological and psychological aspects of brain recovery. Cham: Springer; 2023: 347-65.
  7. Garcia D. The big, the dark, and the biopsychosocial shades of harmony: Personality traits and harmony in life. Behav Sci 2024; 14(10): 873-86
  8. Garcia D, Lester N, Cloninger KM, Cloninger RC. Temperament and Character Inventory (TCI). In: Encyclopedia of personality and individual differences. Cham: Springer; 2020: 5408-10.
  9. Zeigler-Hill V, Shackelford TK. Encyclopedia of personality and individual differences. Cham: Springer; 2020.
  10. Laricchiuta D, Garofalo C, Mazzeschi C. Trauma-related disorders and the bodily self: Current perspectives and future directions. Front Psychol 2023; 14: 1166127.
  11. Melchers KG, Basch JM. Playful personnel selection: The use of traditional versus game-related personnel selection methods and their perception from the recruiters’ and applicants’ perspectives. Int J Sel Assess 2024; 32(3): 1-18.
  12. Takahashi M, Shirayama Y, Muneoka K, Suzuki M, Sato K, Hashimoto K. Personality traits as risk factors for treatment-resistant depression. PLoS ONE 2023; 8(5): e63756.
  13. Havlik JL, Wahid S, Teopiz KM, McIntyre RS, Krystal JH, Rhee TG. Recent advances in the treatment of treatment-resistant depression: A narrative review of literature published from 2018 to 2023. Curr Psychiatry Rep 2024; 26: 176-213.
  14. Jeffrey J, Klomhaus A, Aralis H, Barrera W, Rosenberg S, Grossman M, et al. Factors associated with response and remission from depression at 6-months of treatment in a retrospective cohort treated within an integrated care program. BMC Health Serv Res 2021; 21: 703.
  15. Asano T, Baba H, Kawano R, Takei H, Maeshima H, Takahashi Y, et al. Temperament and character as predictors of recurrence in remitted patients with major depression: a 4-year prospective follow-up study. Psychiatry Res 2015; 225(3): 322-5.
  16. Kaviani H, Pournasseh M, Mousavi A. [Standardization and validation of the revised Eysenck personality questionnaire in the Iranian population]. Iranian Journal of psychiatry and clinical psychology 2005; 11(3): 304-11. (Persian)
  17. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory-Second edition: BDI-II-Persian. Depress Anxiety 2005; 21(4):185-92.
  18. American Psychiatric Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV). Washington. D.C.: American Psychiatric Association; 1994.
  19. First MB, Spitzer RL, Gibbon M, Williams JB. User's guide for the structured clinical interview for DSM-IV axis I disorders SCID-I: Clinician version. D.C.: American Psychiatric Association; 1997.
  20. Mohammadkhani P, Jahanitabesh A, Tamannaeefar S. [Structured clinical interview for DSM-IV disorders]. Tehran: Faradid; 2005. (Persian)
  21. Elsayir HA. The role of effect size and significance test in research design and analysis. Edelweiss applied science and technology 2024; 8(6): 287-95.
  22. Nixon SJ, Parsons OA. Cloninger's tridimensional theory of personality: Construct validity in a sample of college students. Pers Individ Dif 1989; 10(12): 1261-7.
  23. Cloninger CR, Przybeck TR, Svrakic DM. The tridimensional personality questionnaire: US normative data. Psychol Rep 1991; 69(3): 1047-57.
  24. Moriarty AS, Meader N, Snell KI, Riley RD, Paton LW, Dawson S, et al. Predicting relapse or recurrence of depression: Systematic review of prognostic models. Br J Psychiatry 2022; 221(2): 448-58.
  25. Dunlop BW, Holland P, Bao W, Ninan PT, Keller MB. Recovery and subsequent recurrence in patients with recurrent major depressive disorder. J Psychiatr Res 2012; 46(6): 708-15.
  26. Richter J, Eisemann M. Self-directedness as a cognitive feature in depressive patients. Pers Individ Dif 2002; 32(8): 1327-37.
  27. Garcia D, Anckarsäter H, Lundström S. Self-directedness and cooperativeness, psychosocial dysfunction and suffering in ESSENCE. The scientific world journal 2013; 2013(1): 416981.
  28. Schanz CG, Equit M, Schäfer SK, Michael T. Self-directed passive-aggressive behaviour as an essential component of depression: Findings from two cross-sectional observational studies. BMC Psychiatry 2022; 22(1): 200.
  29. Kitamura T, Kijima N, Watanabe K, Takezaki Y. Precedents of perceived social support: Personality and early life experiences. Psychiatry Clin Neurosci 1999; 53(6): 649-54.
Journal of Fundamentals of Mental Health
Volume 27, Issue 1
January and February 2025
Pages 19-25

Files

Share

How to cite

Statistics