Personality test and prediction of antidepressive treatment effect in mental illness

INTRODUCTION: The STAR*D project showed that standard treatment of patients with major depression with citalopram resulted in a 36.8% remission in a group of patients. A switch to or supplementing with cognitive therapy substantially increased the remission rate. It would be desirable to identify in advance those patients in whom adjuvant therapy would be of a special benefit. MATERIAL AND METHODS: Answers to questions about personality traits (Temperament and Character Inventory (TCI)) were gathered from a mixed group of hospitalized and ambulant Danish psychiatric patients (n = 63) and matched with answers to questions on quality of life and degree of depression (Major Depression Inventory (MDI)). The hospitalized patients answered those questions again when discharged. Confirmatory factor analysis was used to evaluate the quality of the questions with regard to their information on latent categories and dimensions. RESULTS: A number of the questions were of low quality and could be omitted in this group of patients. The revised personality profile showed that patients with a higher score for harm avoidance also had a higher depression score measured at discharge from the hospital or during ambulant treatment. CONCLUSION: The TCI screening identifies a group of patients that have a high risk of getting a limited antidepressive treatment effect. An adjuvant intervention to the psychopharmacologic treatment could be offered, e.g. cognitive therapy.