Dimensions of temperament and character as predictors of antidepressant discontinuation, response and adverse reactions during treatment with nortriptyline and escitalopram
| Autor: | Ole Köhler-Forsberg, Peter McGuffin, Katherine J. Aitchison, Marcella Rietschel, Robert Keers, Rudolf Uher, Anne Farmer, Ole Mors, Wolfgang Maier, Joanna Hauser |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2023 |
| Předmět: |
response
business.industry major depressive disorder (MDD) media_common.quotation_subject Cooperativeness Novelty seeking Antidepressant medicine.disease Discontinuation Psychiatry and Mental health personality depression Medicine Escitalopram Personality Harm avoidance Temperament Nortriptyline business Applied Psychology medicine.drug media_common Clinical psychology discontinuation |
| Zdroj: | Köhler-Forsberg, O, Keers, R, Uher, R, Hauser, J, Maier, W, Rietschel, M, McGuffin, P, Farmer, A E, Aitchison, K J & Mors, O 2023, ' Dimensions of temperament and character as predictors of antidepressant discontinuation, response and adverse reactions during treatment with nortriptyline and escitalopram ', Psychological Medicine, vol. 53, no. 6, pp. 2522-2530 . https://doi.org/10.1017/S003329172100444X |
| ISSN: | 0033-2917 |
| DOI: | 10.1017/S003329172100444X |
| Popis: | BackgroundPersonality 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.MethodsGENDEP 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.ResultsLow 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.ConclusionsThis 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|