Personality and risk of hospital diagnosed mental disorder: a 35 years' prospective study

Personality in Type 1 Diabetes and the Impact of Personality Traits on the Effects of Introducing Diabetes Technology

Aim

How well new technology is applied to the daily management of type 1 diabetes (T1D) may be highly influenced by personality traits. The number of studies examining how personality traits influence diabetes self-management technologies such as continuous glucose monitoring and carbohydrate counting with automated insulin bolus calculation based on carbohydrate ratios and insulin sensitivity is scarce. Derived from a randomized controlled trial, we aimed to examine the association between personality traits and glycemic and patient-reported outcomes in adults with T1D on multiple daily insulin injections initiating flash glucose monitoring and carbohydrate counting with automated bolus calculation.

Methods

Personality trait scores from The Five-Factor Inventory-3 were analyzed in 170 individuals. We assessed baseline (n = 168) and changes (n = 34) in HbA1c, and patient-reported outcomes (validated questionnaires on diabetes distress, diabetes treatment satisfaction, diabetes psychosocial self-efficacy, diabetes quality of life) in bivariate and partial correlation analyses with personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness).

Results

Adjusted for sex, age, and diabetes debut age, higher agreeableness correlated negatively with baseline HbA1c (partial correlation -0.20, p < 0.05) but positively with HbA1c change over time (0.36, p < 0.05). Higher neuroticism score was associated with higher baseline distress (0.39, p < 0.001) and lower baseline psychosocial self-efficacy (-0.43, p < 0.001), quality of life (-0.32, p < 0.001) and treatment satisfaction (-0.18, p < 0.05).

Conclusion

This study confirms that personality traits are associated with glycemia and patient-reported outcomes in adults with T1D. Consequently, tailored diabetes management approaches are likely to enhance overall outcomes, especially when incorporating diabetes technology.

The Balance in the Head: How Developmental Factors Explain Relationships Between Brain Asymmetries and Mental Diseases

Cerebral lateralisation is a core organising principle of the brain that is characterised by a complex pattern of hemispheric specialisations and interhemispheric interactions. In various mental disorders, functional and/or structural hemispheric asymmetries are changed compared to healthy controls, and these alterations may contribute to the primary symptoms and cognitive impairments of a specific disorder. Since multiple genetic and epigenetic factors influence both the pathogenesis of mental illness and the development of brain asymmetries, it is likely that the neural developmental pathways overlap or are even causally intertwined, although the timing, magnitude, and direction of interactions may vary depending on the specific disorder. However, the underlying developmental steps and neuronal mechanisms are still unclear. In this review article, we briefly summarise what we know about structural, functional, and developmental relationships and outline hypothetical connections, which could be investigated in appropriate animal models. Altered cerebral asymmetries may causally contribute to the development of the structural and/or functional features of a disorder, as neural mechanisms that trigger neuropathogenesis are embedded in the asymmetrical organisation of the developing brain. Therefore, the occurrence and severity of impairments in neural processing and cognition probably cannot be understood independently of the development of the lateralised organisation of intra- and interhemispheric neuronal networks. Conversely, impaired cellular processes can also hinder favourable asymmetry development and lead to cognitive deficits in particular.

Neuroticism and extraversion as predictors of first-lifetime onsets of depression, anxiety, and suicidality in high-risk adolescents

There is substantial evidence that personality traits, in particular neuroticism and extraversions predict depressive and anxiety episodes as well as suicidal ideation. However, little research has examined whether these traits predict the first onset of depressive and anxiety disorders and suicidal ideation. Moreover, the few studies to date have not adjusted for pre-existing subthreshold symptoms, assessed dimensionally. In this study, 144 adolescents were assessed at baseline, 9-, and 18-month follow-ups. Neuroticism and extraversion were assessed via self-report, and depressive and anxiety disorders and suicidal ideation were assessed with diagnostic interviews. Adjusting for age, sex, and baseline symptoms, logistic regression analyses showed that neuroticism predicted the first onset of depressive disorders. However, neither neuroticism nor extraversion predicted first onsets of anxiety disorders, extraversion did not predict depressive disorders, and neither trait predicted suicidal ideation onset or severity after adjusting for baseline symptoms. Neuroticism and extraversion may respectively predispose youth to depressive or anxiety disorders but not to suicidal ideation over and above pre-existing symptoms. Results have implications for the early identification of at-risk youth and prevention of depressive and anxiety disorders and suicidal ideation.

Is adjustment disorder genetically correlated with depression, anxiety, or risk-tolerant personality trait?

Adjustment disorder has three main subtypes: adjustment disorder with depressed mood, adjustment disorder with anxiety, and adjustment disorder with disturbance of conduct. The disorder is moderately heritable and has lifetime comorbidities with major depressive disorder (MDD), anxiety disorders, or risk-tolerant personality. However, it remains unclear whether the degrees of genetic correlations between adjustment disorder and other psychiatric disorders and intermediate phenotypes are similar or different to those between MDD, anxiety disorders or risk-tolerant personality and these other psychiatric disorders and intermediate phenotypes. To compare patterns of genetic correlations, we utilized large-scale genome-wide association study summary statistics for adjustment disorder-related disorders and personality trait, eleven other psychiatric disorders and fifteen intermediate phenotypes. Adjustment disorder had highly positive genetic correlations with MDD, anxiety disorders, and risk-tolerant personality. Among other psychiatric disorders, adjustment disorder, MDD, anxiety disorders and risk-tolerant personality were positively correlated with risks for schizophrenia (SCZ), bipolar disorder (BD), SCZ + BD, attention-deficit/hyperactivity disorder, and cross disorders. In contrast, adjustment disorder was not significantly correlated with risks for obsessive-compulsive disorder, Tourette syndrome, or posttraumatic stress disorder despite significant genetic correlations of MDD or anxiety disorders with these disorders. Among intermediate phenotypes, adjustment disorder, MDD, anxiety disorders, and risk-tolerant personality commonly had a younger age at first sexual intercourse, first birth, and menopause, lower cognitive ability, and higher rate of smoking initiation. Adjustment disorder was not genetically correlated with extraversion, although the related disorder and personality were correlated with extraversion. Only adjustment disorder was correlated with a higher smoking quantity. These findings suggest that adjustment disorder could share a genetic etiology with MDD, anxiety disorders and risk-tolerant personality trait, as well as have a disorder-specific genetic etiology.

The association of personality polygenic risk score, psychosocial protective factors and suicide attempt in mood disorder

Some personality traits, especially neuroticism, has been found to be associated with suicide attempt (SA) in mood disorder patients. The present study explored the association between personality traits and SA using polygenic risk scores (PRS) for personality among patients with mood disorders. We also investigated the effects of a variety of psychosocial variables on SA. Patients with bipolar disorder (BPD, N = 841) and major depressive disorder (MDD, N = 710) were recruited from hospitals in Taiwan. Lifetime SA and information on psychosocial factors was collected. We calculated the PRS of neuroticism and extraversion. A trend test for SA was performed across quartiles of the PRS for neuroticism and extraversion, and logistic regression analyses were performed to examine the associations between psychosocial factors and SA, accounting for the PRS of personality traits. The prevalence of SA was higher in MDD than in BPD patients. The risk of SA was elevated in MDD patients with a higher quintile of PRS in neuroticism and a lower quintile of PRS in extraversion. The multiple regression analysis results demonstrated that later age of onset, higher family support and resilience, and lower overall social support were protective factors against SA. From the perspective of suicide prevention efforts, strengthening family support and conducting resilience training for patients with mood disorders may be beneficial interventions in clinical settings.