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Joosten F, Bakker J, Daemen M, van Amelsvoort T, Reininghaus U. Looking for the good in times of adversity: Examining the interplay of temperament and social schemas in shaping resilience in youth. Early Interv Psychiatry 2024. [PMID: 38642010 DOI: 10.1111/eip.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/14/2024] [Accepted: 04/08/2024] [Indexed: 04/22/2024]
Abstract
AIM Resilience is a broad and dynamic concept that can be seen as being constituted by the combination of internal factors, for example, temperament profiles, and external factors, for example, social support. This paper aimed to identify temperament profiles in help-seeking youth exposed to adverse childhood experiences, and to investigate whether temperament (putative internal protective factor) interacts with social schemas (as proxy for the putative external protective factor social support) such that their combination is associated with (a) reduced mental health problems and (b) attenuated decrease in positive affect following daily life stressors. METHODS Self-report questionnaires were used to measure temperament, social schemas and mental health problems. The experience sampling method was used to assess stress and positive affect (i.e., stress-sensitivity as a potential daily life resilience mechanism). Temperament profiles were identified by latent profile analysis and regression analyses were used to examine (interaction) effects. RESULTS In 138 subjects, three temperament profiles were identified, that is, a moderate, volatile and persevering profile, of which the latter was negatively associated with mental health problems. Neither mental health problems nor stress sensitivity were found to be affected by the interaction between temperament and social schemas. However, positive social schemas were found to be independently associated with reduced mental health problems (b = -4.41; p = <.001) and reduced stress sensitivity (b = .10, p = .044). CONCLUSIONS Findings are relevant for both practice and research, and contribute to improving our understanding of putative protective factor in the development of mental ill-health, thereby further unravelling the construct of resilience.
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Affiliation(s)
- Frankie Joosten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Child en Youth Mental Health, Mondriaan Mental Health Centre, Heerlen, The Netherlands
| | - Jindra Bakker
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Child en Youth Mental Health, Mondriaan Mental Health Centre, Heerlen, The Netherlands
| | - Maud Daemen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Child en Youth Mental Health, Mondriaan Mental Health Centre, Heerlen, The Netherlands
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- ESRC Centre for Society & Mental Health, King's College London, London, UK
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Ovchinnikov AV, Vazagaeva TI, Akhapkin RV, Volel BA. Predictive capabilities of the Cloninger Temperament and Character Inventory (TCI) in evaluating the effectiveness of antidepressant pharmacotherapy. Systematic review and meta-analysis. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2023. [DOI: 10.14412/2074-2711-2023-1-4-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A. V. Ovchinnikov
- National Medical Research Center for Psychiatry and Narcology named after V.P. Serbsky, Ministry of Health of Russia
| | - T. I. Vazagaeva
- National Medical Research Center for Psychiatry and Narcology named after V.P. Serbsky, Ministry of Health of Russia
| | - R. V. Akhapkin
- National Medical Research Center for Psychiatry and Narcology named after V.P. Serbsky, Ministry of Health of Russia
| | - B. A. Volel
- N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
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Default mode network alterations after intermittent theta burst stimulation in healthy subjects. Transl Psychiatry 2020; 10:75. [PMID: 32094326 PMCID: PMC7040002 DOI: 10.1038/s41398-020-0754-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 01/13/2020] [Accepted: 01/13/2020] [Indexed: 12/15/2022] Open
Abstract
Understanding the mechanisms by which intermittent theta burst stimulation (iTBS) protocols exert changes in the default-mode network (DMN) is paramount to develop therapeutically more effective approaches in the future. While a full session (3000 pulses) of 10 Hz repetitive transcranial magnetic stimulation (HF-rTMS) reduces the functional connectivity (FC) of the DMN and the subgenual anterior cingulate cortex, the current understanding of the effects of a single session of iTBS on the DMN in healthy subjects is limited. Here, we use a previously validated target selection approach for an unprecedented investigation into the effects of a single session (1800 pulses) of iTBS over the DMN in healthy controls. Twenty-six healthy subjects participated in a double-blind, crossover, sham-controlled study. After iTBS to the personalized left dorsolateral prefrontal cortex (DLPFC) targets, we investigated the time lapse of effects in the DMN and its relationship to the harm avoidance (HA) personality trait measure (Temperament and Character Inventory/TCI). Approximately 25-30 min after stimulation, we observed reduced FC between the DMN and the rostral and dorsal anterior cingulate cortex (dACC). About 45 min after stimulation the FC of rostral and dACC strongly decreased further, as did the FC of right anterior insula (AI) with the DMN. Also, we report a positive correlation between the FC decrease in the rostral ACC and the HA domain of TCI, indicating that the HA scores can potentially predict iTBS response. Overall, our results show the time lapse by which iTBS at left-DLPFC targets reduces the FC between DMN and the dACC and right AI, regions typically described as nodes of the salience network.
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Balestri M, Porcelli S, Souery D, Kasper S, Dikeos D, Ferentinos P, Papadimitriou GN, Rujescu D, Martinotti G, Di Nicola M, Janiri L, Caletti E, Mandolini GM, Pigoni A, Paoli RA, Lazzaretti M, Brambilla P, Sala M, Abbiati V, Bellani M, Perlini C, Rossetti MG, Piccin S, Bonivento C, Fabbro D, Damante G, Ferrari C, Rossi R, Pedrini L, Benedetti F, Montgomery S, Zohar J, Mendlewicz J, Serretti A. Temperament and character influence on depression treatment outcome. J Affect Disord 2019; 252:464-474. [PMID: 31005789 DOI: 10.1016/j.jad.2019.04.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 03/07/2019] [Accepted: 04/07/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND personality features have been repeatedly associated with depression treatment outcome in Major Depressive Disorder (MDD), however conclusive results are still lacking. Moreover, as for Bipolar Disorder (BD), results are only few and preliminary. AIM the aim of the present study was to perform an exploratory investigation of the influence of personality traits as assessed by the Temperament and Character Inventory (TCI), on principal depression treatment outcomes (non remission, non response and resistance). METHODS 743 mood disorders patients (455 MDD (61.24%) and 288 BD (38.76%)) were recruited in the context of 6 European studies. Generalized logit models were performed to test the effects of TCI dimensions on treatment outcomes, considering possible confounders such as age, gender and education. Positive results were controlled for comorbidities (anxiety and substance use disorders) as well. RESULTS MDD Non-Remitters showed high Harm Avoidance (HA) and Self Transcendence (ST) (p = 0.0004, d = 0.40; p = 0.007, d = 0.36 respectively) and low Persistence (P) and Self Directedness (SD) (p = 0.05; d = 0.18; p = 0.002, d = 0.40, respectively); MDD Non-Responders showed a slightly different profile with high HA and low Reward Dependence (RD) and SD; finally, MDD Resistants showed low RD, P and Cooperativeness (C). In BD patients, only higher HA in non response was observed. LIMITATIONS the retrospective cross-sectional design, the TCI assessment regardless of the mood state and the small number of bipolar patients represent the main limitations. CONCLUSION specific TCI personality traits are associated with depression treatment outcome in MDD patients. The inclusion of such personality traits, together with other socio-demographic and clinical predictors, could ameliorate the accuracy of the prediction models available to date.
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Affiliation(s)
- Martina Balestri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy
| | - Stefano Porcelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy
| | - Daniel Souery
- Laboratoire de Psychologie Médicale, Université Libre de Bruxelles, Centre Européen de Psychologie Médicale-PsyPluriel, Brussels, Belgium
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Dimitris Dikeos
- Department of Psychiatry, Athens University Medical School, Athens, Greece
| | | | | | - Dan Rujescu
- University Clinic for Psychiatry, Psychotherapy and Psychosomatic, Martin-Luther-University Halle-Wittenberg, Germany
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Scienze Cliniche, University "G.d'Annunzio", Chieti, Italy
| | - Marco Di Nicola
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Luigi Janiri
- Fondazione Policlinico Universitario "A. Gemelli" - IRCCS, Catholic University of Sacred Heart, Rome, Italy
| | - Elisabetta Caletti
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Gian Mario Mandolini
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Riccardo Augusto Paoli
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Matteo Lazzaretti
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Michela Sala
- Department of Mental Health, Azienda Sanitaria Locale Alessandria, Alessandria, Italy
| | - Vera Abbiati
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marcella Bellani
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy; UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Italy
| | - Cinzia Perlini
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy; UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Italy
| | - Maria Gloria Rossetti
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry and Clinical Psychology, University of Verona, Verona, Italy; UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata Verona (AOUI), Italy
| | - Sara Piccin
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Carolina Bonivento
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Dora Fabbro
- Department of Laboratory Medicine, Institute of Medical Genetics, University of Udine, Italy
| | - Giuseppe Damante
- Department of Laboratory Medicine, Institute of Medical Genetics, University of Udine, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio FBF, Brescia, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio FBF, Brescia, Italy
| | - Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio FBF, Brescia, Italy
| | - Francesco Benedetti
- Division of Neuroscience, San Raffaele Scientific Institute, Milan, Italy, University Vita-Salute San Raffaele, Milan, Italy
| | | | - Joseph Zohar
- Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy.
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Personalized repetitive transcranial magnetic stimulation temporarily alters default mode network in healthy subjects. Sci Rep 2019; 9:5631. [PMID: 30948765 PMCID: PMC6449366 DOI: 10.1038/s41598-019-42067-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 03/19/2019] [Indexed: 12/27/2022] Open
Abstract
High frequency repetitive transcranial magnetic stimulation (HF-rTMS) delivered to the left dorsolateral prefrontal cortex (DLPFC) is an effective treatment option for treatment resistant depression. However, the underlying mechanisms of a full session of HF-rTMS in healthy volunteers have not yet been described. Here we investigated, with a personalized selection of DLPFC stimulation sites, the effects driven by HF-rTMS in healthy volunteers (n = 23) over the default mode network (DMN) in multiple time windows. After a complete 10 Hz rTMS (3000 pulses) session, we observe a decrease of functional connectivity between the DMN and the subgenual Anterior Cingulate Cortex (sgACC), as well as the ventral striatum (vStr). A negative correlation between the magnitude of this decrease in the right sgACC and the harm avoidance domain measure from the Temperament and Character Inventory was observed. Moreover, we identify that coupling strength of right vStr with the DMN post-stimulation was proportional to a decrease in self-reports of negative mood from the Positive and Negative Affect Schedule. This shows HF-rTMS attenuates perception of negative mood in healthy recipients in agreement with the expected effects in patients. Our study, by using a personalized selection of DLPFC stimulation sites, contributes understanding the effects of a full session of rTMS approved for clinical use in depression over related brain regions in healthy volunteers.
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Gurpegui D, Ortuño F, Gurpegui M. Temperament traits and remission of depression: A naturalistic six-month longitudinal study. J Affect Disord 2019; 243:494-502. [PMID: 30286414 DOI: 10.1016/j.jad.2018.09.041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/22/2018] [Accepted: 09/15/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The aim of this naturalistic longitudinal study was to add evidence regarding the potential of Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) for predicting the effect of pharmacological treatment on the rates of therapeutic response and remission. METHODS The study was based on 200 outpatients with unipolar depressive disorders of different severity and course of illness, and extended up to 6 months of follow-up. Patients were assessed in their temperament with the Tridimensional Personality Questionnaire (TPQ) and their condition was classified (in course and severity) according to the International Classification of Diseases, Tenth revision (ICD-10) diagnostic criteria for research. Patients were blindly rated (concerning other predicting variables) on the improved Clinical Global Impression-Severity scale for depression (iCGI-S) at baseline, 6 weeks, 3 months and 6 months. Outcome measures at the last observation carried forward were therapeutic response (reduction of ≥50% in the last iCGI-S) and remission (last iCGI-S = 0), which were available for 187 patients. RESULTS Remission was independently and directly associated with length of follow-up, and inversely with the baseline iCGI-S score and harm avoidance (patients in the high tertile had a 2.7 likelihood of non-remission in comparison with those in the low tertile); persistence was found to have a complex, V-shape relationship with remission. Within a sub-sample of more severe cases (n = 118), having higher harm avoidance scores, a more favorable outcome was associated with higher reward dependence and the non-smoking condition. LIMITATIONS With a naturalistic, non-experimental design, the sample may not be representative of the general population. CONCLUSIONS Temperament traits may help predict outcome in patients treated for depression.
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Affiliation(s)
- David Gurpegui
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - Felipe Ortuño
- Department of Psychiatry and Medical Psychology, Faculty of Medicine and Clínica Universidad de Navarra, Universidad de Navarra, Pamplona, Spain
| | - Manuel Gurpegui
- Department of Psychiatry, Faculty of Medicine, CTS-549 Research Group, Institute of Neurosciences, Universidad de Granada, Av. Investigación 11 - Torre A, Planta 9, E-18071 Granada, Spain.
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Aluoja A, Tõru I, Raag M, Eller T, Võhma Ü, Maron E. Personality traits and escitalopram treatment outcome in major depression. Nord J Psychiatry 2018; 72:354-360. [PMID: 29688152 DOI: 10.1080/08039488.2018.1465590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Selective serotonin re-uptake inhibitors (SSRI) have proven to be effective in treatment of depression. Still, treatment efficacy varies significantly from patient to patient and about 40% of patients do not respond to initial treatment. Personality traits have been considered one source of variability in treatment outcome. AIM Current study aimed at identifying specific personality traits that could be predictive of treatment response and/or the dynamics of symptom change in depressive patients. METHOD In a sample of 132 outpatients with major depressive disorder (MDD) treated with an SSRI-group antidepressant escitalopram, the Swedish universities Scales of Personality (SSP) were used in order to find predictive personality traits. For the assessment of the severity of depressive symptoms and the improvement rates, the Hamilton Depression Scale (HAM-D) and Montgomery-Åsberg Depression Rating Scale (MADRS) were used. RESULTS Escitalopram-treated MDD patients with higher social desirability achieved more rapid decrease in symptom severity. None of the studied traits predicted the end result of the treatment. CONCLUSION The findings suggest that specific personality traits may predict the trajectory of symptom change rather than the overall improvement rate.
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Affiliation(s)
- Anu Aluoja
- a Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Innar Tõru
- a Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Mait Raag
- b Institute of Family Medicine and Public Health, University of Tartu , Tartu , Estonia
| | - Triin Eller
- a Department of Psychiatry , University of Tartu , Tartu , Estonia
| | - Ülle Võhma
- c Psychiatry Clinic , North Estonia Medical Centre Foundation , Tallinn , Estonia
| | - Eduard Maron
- a Department of Psychiatry , University of Tartu , Tartu , Estonia.,c Psychiatry Clinic , North Estonia Medical Centre Foundation , Tallinn , Estonia.,d Centre for Neuropsychopharmacology , Imperial College London , London , UK
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Trofimova I, Sulis W. There is more to mental illness than negative affect: comprehensive temperament profiles in depression and generalized anxiety. BMC Psychiatry 2018; 18:125. [PMID: 29747614 PMCID: PMC5946468 DOI: 10.1186/s12888-018-1695-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 04/16/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Temperament and mental illness are thought to represent varying degrees along the same continuum of neurotransmitter imbalances. A taxonomy of temperament could provide the basis for a new taxonomy of mental illness. Most popular models of temperament, being based heavily on emotionality traits, show very poor ability to discriminate between mental disorders. The main goal of this study was to examine whether a temperament model based on modern neurophysiology and possessing an extensive set of non-emotionality traits provides better discrimination between Major Depression (MD), Generalized Anxiety (GAD) and Comorbid MD and GAD, in comparison to emotionality-based temperament models. METHODS Using the Structure of Temperament Questionnaire, the temperament profiles of 687 individuals (396 clients of private psychiatric and psychological practice, and 291 control subjects) were compared across four adult age groups (18-24, 25-45, 46-65, 66-84). RESULTS MD and GAD appear to be accurately distinguished by the traits of Motor Endurance and Motor Tempo (much lower values in depression), and Neuroticism (much higher value in anxiety). Comorbids can be distinguished based on a significant decrease in the traits of Plasticity, Intellectual Endurance, Sensitivity to Probabilities, and increased Impulsivity. These effects seemed independent of age and gender. CONCLUSIONS The results suggest the benefits of including non-emotionality-related traits and the usefulness of a functional approach to both taxonomy of temperament and classification of mental disorders.
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Affiliation(s)
- Irina Trofimova
- Collective Intelligence Laboratory, Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada. .,, Hamilton, Canada.
| | - William Sulis
- Collective Intelligence Laboratory, Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Canada ,Cayuga, Canada
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Marquez-Arrico JE, Río-Martínez L, Navarro JF, Prat G, Adan A. Personality Profile and Clinical Correlates of Patients With Substance Use Disorder With and Without Comorbid Depression Under Treatment. Front Psychiatry 2018; 9:764. [PMID: 30687142 PMCID: PMC6336829 DOI: 10.3389/fpsyt.2018.00764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/20/2018] [Indexed: 01/05/2023] Open
Abstract
Background: Among patients with substance use disorder (SUD), major depressive disorder (MDD) is highly prevalent. Even though, personality plays an important role in treatment outcomes for individuals with SUD and SUD + MDD, few studies have explored personality characteristics in these samples. This study aims to describe personality for patients with SUD taking into account the comorbid MDD, using the Alternative Five Factor Model (AFFM). We also aim to compare SUD + MDD patients with population norms and to elucidate possible personality clinical correlates. Methods: For our study, 116 male patients undergoing for SUD treatment were divided in two groups: SUD only (N = 58) and SUD + MDD (N = 58). To examine personality, we used the Zuckerman-Kuhlman Personality Questionnaire and multiple analyses of covariance were performed to identify differences. In a first analysis, age was introduced as a covariate whereas in a second analysis the continuous variables that showed to have a discriminant value for the groups were added as covariates. Variables predicting the presence of dual diagnosis and personality clinical correlates were analyzed by logistic and linear regression models, respectively. We observed that patients with SUD + MDD show distinctive personality characteristics compared with patients with SUD only and population norms. Results: According to the AFFM, SUD + MDD patients are characterized by higher Neuroticism-Anxiety (positively associated to depressive symptoms) and Impulsivity; and by lower Parties and Friends. Moreover, the probability of having a dual depressive disorder was represented by the amount of medications and substances used. The preference for hard work and the energy self-reported levels (Work Activity trait) are linked to these clinical variables rather than to the presence/absence of a dual depressive disorder. Conclusions: Even when controlling clinical variables related to a higher probability of having a dual depressive disorder, the Neuroticism-Anxiety is a personality trait that strongly differentiates between SUD only and SUD + MDD patients. Further investigation is needed to explore the role of this personality trait as endophenotype in dual depressive men. Our results underline the importance of a dimensional understanding of personality and its clinical correlates among patients with SUD + MDD; this approach could provide us information on specific treatment strategies to improve the prognosis of patients.
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Affiliation(s)
- Julia Elena Marquez-Arrico
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | - Laura Río-Martínez
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | | | - Gemma Prat
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain
| | - Ana Adan
- Department of Clinical Psychology and Psychobiology, School of Psychology, University of Barcelona, Barcelona, Spain.,Institute of Neurosciences, University of Barcelona, Barcelona, Spain
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Trofimova IN, Sulis W. A Study of the Coupling of FET Temperament Traits with Major Depression. Front Psychol 2016; 7:1848. [PMID: 27933018 PMCID: PMC5123189 DOI: 10.3389/fpsyg.2016.01848] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 11/08/2016] [Indexed: 01/21/2023] Open
Abstract
Objective: Temperament and mental illness have been linked to the same systems of behavioral regulation. A temperament model, carefully structured to respond to subtle differences within systems of behavior regulation, should exhibit distinct temperament patterns in the presence of mental illness. Previous comparisons of temperament profiles in mental disorders used mostly emotionality-related traits. In contrast, the Functional Ensemble of Temperament (FET) model differentiates not only between emotionality traits, but also between traits related to physical, verbal, and mental aspects of behavior and maps 12 functional aspects of behavior to temperament traits as well as to symptoms of mental illnesses. This article reports on the coupling of sex, age, and temperament traits with Major Depression (MD) using the FET framework. Method: Intake records of 467 subjects, ages 17-24, 25-45, 46-65, 66-84 were examined, with temperament assessed by the Structure of Temperament Questionnaire (based on the FET). Results: The presence of MD was associated with changes in mean temperament scores on 9 of the 12 traits. The results were in line with the DSM-5 criteria of fatigue (patients with MD reported a significant decrease in three types of endurance - motor-physical, social-verbal, and mental), of psychomotor retardation (a significant decrease in physical and social-verbal tempo) and of worthlessness (as low Self-Confidence). The results also showed that three new symptoms, high Impulsivity, high Neuroticism, and diminished Plasticity, should be considered as depressive symptoms in future versions of the DSM. As a significant negative result, no interaction of age or sex (with the exception of the Self-Confidence scale) with MD was found for temperament traits. Conclusion: The value of differentiating between physical, social, and mental aspects of behavior is demonstrated in the differential effects of major depression and gender. The value of differentiating between endurance, dynamical and orientation-related aspects of behavior is also demonstrated. The deleterious impact of MD on temperament scores appeared to be similar across all age groups. The appearance of high impulsivity, neuroticism, and low plasticity deserve further study as associated factors in future versions of the DSM/ICD.
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Affiliation(s)
- Irina N Trofimova
- Collective Intelligence Laboratory, Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton ON, Canada
| | - William Sulis
- Collective Intelligence Laboratory, Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton ON, Canada
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Tomita T, Yasui-Furukori N, Kaneda A, Ishioka M, Sugawara N, Nakagami T, Nakamura K. An attempt to construct a 7-item short version of the temperament and character inventory to predict the treatment response of patients with depression; a validation study. BMC Psychiatry 2016; 16:290. [PMID: 27520460 PMCID: PMC4983023 DOI: 10.1186/s12888-016-0997-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 08/04/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The Temperament and Character Inventory (TCI) is a psychological test that is frequently used to assess personality traits. Many studies have shown the potential of the inventory to predict the treatment response of patients with major depressive disorder (MDD). Previously, we showed the association between 10 items of the TCI and the treatment response. In the present study, we reanalyzed the 10 items and aimed to provide cut-off values. METHODS This work is a secondary analysis of previously published work. Seventy-three patients were enrolled in the previously done study. Participants were treated with 10-40 mg/day of paroxetine for six weeks, and then the participants completed the TCI. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate depression. The participants were divided into two groups (responders and non-responders). Using chi-squared tests, we reanalyzed the 10 items that had the strongest association with the treatment response in the previous study. We rated the answers to each item associated with the treatment response as a "1", and the answers associated with a non-response were rated as a "0". We calculated predictive scores using 10 models. Each model consisted of 1-10 scores of the best 1-10 items. We defined cut-off values for predicting treatment responses using a receiver operating characteristic (ROC) curve analysis. RESULTS Ranked by the strength of the association with the treatment response, items 174, 137, 70, 237, 106, 191, 34, 232, 161, and 215 of the TCI significantly predicted treatment responses. All predictive scores from models 1 to 10 significantly predicted treatment responses. The predictive score threshold of model 7 was 3/4, with an area under the curve of 0.825, and this model showed the highest odds and likelihood ratios (19.3 and 8.86, respectively). CONCLUSIONS We might predict the treatment response of patients with MDD using TCI predictive scoring, including items 174, 137, 70, 237, 106, 191, and 34 and a cut-off value of 3/4.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562, Japan.
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan
| | - Ayako Kaneda
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan
| | - Masamichi Ishioka
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan ,Department of Neuropsychiatry, Hirosaki-Aiseikai Hospital, Hirosaki, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan ,Aomori Prefectural Center for Mental Health and Welfare, Aomori, Japan
| | - Taku Nakagami
- Department of Neuropsychiatry, Odate Municipal General Hospital, Odate, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, 036-8562 Japan
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Use of the Temperament and Character Inventory to Predict Response to Repetitive Transcranial Magnetic Stimulation for Major Depression. J Psychiatr Pract 2016; 22:193-202. [PMID: 27123799 PMCID: PMC4852279 DOI: 10.1097/pra.0000000000000150] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The goal of this study was to investigate the utility of the Temperament and Character Inventory (TCI) in predicting antidepressant response to repetitive transcranial magnetic stimulation (rTMS). BACKGROUND Although rTMS of the dorsolateral prefrontal cortex is an established antidepressant treatment, little is known about predictors of response. The TCI measures multiple personality dimensions (harm avoidance, novelty seeking, reward dependence, persistence, self-directedness, self-transcendence, and cooperativeness), some of which have predicted response to pharmacotherapy and cognitive-behavioral therapy. A previous study suggested a possible association between self-directedness and response to rTMS in melancholic depression, although this was limited by the fact that melancholic depression is associated with a limited range of TCI profiles. METHODS Nineteen patients with a major depressive episode completed the TCI before a clinical course of rTMS over the dorsolateral prefrontal cortex. Treatment response was defined as ≥50% decrease in scores on the Hamilton Rating Scale for Depression (Ham-D). Baseline scores on each TCI dimension were compared between responders and nonresponders through analysis of variance. Pearson correlations were also calculated for temperament/character scores in comparison with percentage improvement in Ham-D scores. RESULTS Eleven of the 19 patients responded to rTMS. T-scores for persistence were significantly higher in responders than in nonresponders (P=0.022). Linear regression revealed a correlation between persistence scores and percentage improvement in Ham-D scores. CONCLUSIONS Higher persistence scores predicted antidepressant response to rTMS. This may be explained by rTMS-induced enhancement of cortical excitability, which has been found to be decreased in patients with high persistence. Personality assessment that includes measurement of TCI persistence may be a useful component of precision medicine initiatives in rTMS for depression.
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Prasko J, Ociskova M, Grambal A, Sigmundova Z, Kasalova P, Marackova M, Holubova M, Vrbova K, Latalova K, Slepecky M. Personality features, dissociation, self-stigma, hope, and the complex treatment of depressive disorder. Neuropsychiatr Dis Treat 2016; 12:2539-2552. [PMID: 27785031 PMCID: PMC5063494 DOI: 10.2147/ndt.s117037] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Identifying the predictors of response to psychiatric and psychotherapeutic treatments may be useful for increasing treatment efficacy in pharmacoresistant depressive patients. The goal of this study was to examine the influence of dissociation, hope, personality trait, and selected demographic factors in treatment response of this group of patients. METHODS Pharmacoresistant depressive inpatients were enrolled in the study. All patients completed Clinical Global Impression - both objective and subjective form (CGI), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) at baseline and after 6 weeks of combined pharmacotherapy and psychotherapy (group cognitive-behavioral or group psychodynamic) treatment as an outcome measures. The Internalized Stigma of Mental Illness Scale (ISMI), Dissociative Experience Scale (DES), Adult Dispositional Hope Scale (ADHS), and Temperament and Character Inventory (TCI-R) were completed at the start of the treatment with the intention to find the predictors of treatment efficacy. RESULTS The study included 72 patients who were hospitalized for the pharmacoresistant major depression; 63 of them completed the study. The mean scores of BDI-II, BAI, subjCGI, and objCGI significantly decreased during the treatment. BDI-II relative change statistically significantly correlated with the total ISMI score, Discrimination Experience (ISMI subscale), and Harm Avoidance (TCI-R personality trait). According to stepwise regression, the strongest factors connected to BDI-II relative change were the duration of the disorder and Discrimination Experience (domain of ISMI). ObjCGI relative change significantly correlated with the level of dissociation (DES), the total ISMI score, hope in ADHS total score, and Self-Directedness (TCI-R). According to stepwise regression, the strongest factor connected to objCGI relative change was Discrimination Experience (domain of ISMI). The existence of comorbid personality disorder did not influence the treatment response. CONCLUSION According to the results of the present study, patients with pharmacoresistant depressive disorders, who have had more experience with discrimination because of their mental struggles, showed a poorer response to treatment.
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Affiliation(s)
- Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Ales Grambal
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Zuzana Sigmundova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Petra Kasalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Marketa Marackova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Michaela Holubova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc; Department of Psychiatry, Hospital Liberec, Liberec, Czech Republic
| | - Kristyna Vrbova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Klara Latalova
- Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc
| | - Milos Slepecky
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovak Republic
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Harm avoidance involved in mediating the association between nerve growth factor (NGF) gene polymorphisms and antidepressant efficacy in patients with major depressive disorder. J Affect Disord 2015; 183:187-94. [PMID: 26021968 DOI: 10.1016/j.jad.2015.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Antidepressants have variable efficacies in subjects with major depressive disorder (MDD). Nerve growth factor (NGF) has been suggested to play an important role in the pathogenesis of depressive symptoms and the response to antidepressant therapy. The aim of this study was to examine whether NGF gene polymorphisms are associated with the antidepressant therapeutic efficacy in subjects with MDD. METHODS A naturalistic follow-up study was carried out on 557 subjects with MDD. Of the enrolled patients, 304 completed the 8-week open-label antidepressant treatment. Seven single-nucleotide polymorphisms (SNPs) of the NGF gene were genotyped. The 21-item Hamilton Depression Rating Scale was used to assess depressive severity from baseline to endpoint. Tridimensional Personality Questionnaire was used to assess baseline personality traits. Single marker and haplotype analyses were conducted. Binary logistic regression was used to calculate odds ratios of remission. Structural equation modeling was used to analyze the predicted mediation effect. RESULTS A significant difference in genotype frequencies between remitters and non-remitters was observed in three NGF SNPs (rs12760036, rs7523654, and rs17033692). The haplotype analysis revealed that the CCC haplotype (rs2254527-rs6678788-rs12760036) was associated with a higher remission rate, while the CCA haplotype was associated with a lower remission rate. The harm avoidance psychological factor partially mediated the effect of NGF variants on antidepressant efficacy. LIMITATIONS The selected SNPs may not cover whole NGF gene. CONCLUSIONS NGF variants are associated with remission rates after 8-week antidepressant treatment, and harm avoidance partially mediated the effect of NGF variants on treatment outcomes.
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15
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Immobility time during the forced swimming test predicts sensitivity to amitriptyline, whereas traveled distance in the circular corridor indicates resistance to treatment in female Wistar rats. Neuroreport 2015; 26:233-8. [DOI: 10.1097/wnr.0000000000000324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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16
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Nomoto H, Baba H, Satomura E, Maeshima H, Takebayashi N, Namekawa Y, Suzuki T, Arai H. Serum brain-derived neurotrophic factor levels and personality traits in patients with major depression. BMC Psychiatry 2015; 15:33. [PMID: 25885038 PMCID: PMC4354762 DOI: 10.1186/s12888-015-0413-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/19/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family of growth factors. Previous studies have demonstrated lower serum BDNF levels in patients with major depressive disorder (MDD) and reported an association between BDNF levels and depression-related personality traits in healthy subjects. The aim of the present study was to explore for a possible association between peripheral BDNF levels and personality traits in patients with MDD. METHODS In this cross-sectional study, a total of 123 inpatients with MDD (Diagnostic and Statistical Manual for Mental Disorders, 4th edition) at the Juntendo University Koshigaya Hospital were recruited. Serum levels of BDNF were measured. Personality traits were assessed using the 125-item short version of the Temperament and Character Inventory (TCI). RESULTS Multiple regression analysis adjusted for age, sex, body mass index, dose of antidepressant, and depression severity showed that TCI Self-Directedness (SD) scores were negatively associated with serum BDNF levels (β = -0.23, p = 0.026). CONCLUSIONS MDD patients who have low SD did not show the reduction in serum BDNF levels that is normally associated with depressive state. Our findings suggest that depression-related biological changes may not occur in these individuals.
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Affiliation(s)
- Hiroshi Nomoto
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan.
| | - Hajime Baba
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan. .,Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, 560 Fukuroyama, 343-0032, Koshigaya, Saitama, Japan.
| | - Emi Satomura
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan.
| | - Hitoshi Maeshima
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan. .,Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, 560 Fukuroyama, 343-0032, Koshigaya, Saitama, Japan.
| | - Naoko Takebayashi
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan. .,Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, 560 Fukuroyama, 343-0032, Koshigaya, Saitama, Japan.
| | - Yuki Namekawa
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan. .,Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, 560 Fukuroyama, 343-0032, Koshigaya, Saitama, Japan.
| | - Toshihito Suzuki
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan. .,Juntendo University Mood Disorder Project (JUMP), Department of Psychiatry, Juntendo University Koshigaya Hospital, 560 Fukuroyama, 343-0032, Koshigaya, Saitama, Japan.
| | - Heii Arai
- Department of Psychiatry, Juntendo University, School of Medicine, 2-1-1 Hongo, Tokyo, Bunkyo-ku, Japan.
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17
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Takahashi M, Suzuki M, Muneoka K, Tsuruoka Y, Sato K, Shirayama Y. Personality traits as predictors for the outcome of lithium augmentation in treatment-resistant depression. Psychiatry Res 2014; 220:1144-6. [PMID: 25453642 DOI: 10.1016/j.psychres.2014.09.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/27/2014] [Accepted: 09/30/2014] [Indexed: 11/16/2022]
Abstract
The NEO Personality Inventory-Revised (NEO) and the Temperament and Character Inventory (TCI) were administered to patients with treatment-resistant depression (n=21) before lithium augmentation. Analysis showed that the poor outcome group (n=11) had lower openness scores on the NEO, and lower cooperativeness scores on the TCI compared with the good outcome group (n=10). These findings may be predictors of poor responsiveness to lithium augmentation in the treatment of antidepressant-resistant depression.
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Atiye M, Miettunen J, Raevuori-Helkamaa A. A meta-analysis of temperament in eating disorders. EUROPEAN EATING DISORDERS REVIEW 2014; 23:89-99. [PMID: 25546554 DOI: 10.1002/erv.2342] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 11/09/2022]
Abstract
Although suggested as an important contributor to the development and maintenance of eating disorders, temperament has not previously been studied adopting a meta-analytical approach. We therefore pooled data (N = 14 studies; N = 3315 cases, N = 3395 controls) on Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders not otherwise specified. Persistence was significantly higher than in the controls in all eating disorders except for BED the highest levels being observed in AN. Correspondingly, the highest effect sizes for harm avoidance were seen in AN. Novelty seeking was significantly elevated relative to the controls only in BN. Harm avoidance was significantly lower, and reward dependence was significantly higher in individuals who had recovered from AN than in those who remained ill. Future studies with a longitudinal design are needed to explore the temporal relationships between eating disorders and temperament traits.
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Affiliation(s)
- Minna Atiye
- Hjelt Institute, Department of Public Health, University of Helsinki, Finland
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19
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Baeken C, Desmyter S, Duprat R, De Raedt R, Van Denabbeele D, Tandt H, Lemmens GMD, Vervaet M, van Heeringen K. Self-directedness: an indicator for clinical response to the HF-rTMS treatment in refractory melancholic depression. Psychiatry Res 2014; 220:269-74. [PMID: 25175912 DOI: 10.1016/j.psychres.2014.07.084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 07/27/2014] [Accepted: 07/31/2014] [Indexed: 12/26/2022]
Abstract
Although well-defined predictors of response are still unclear, clinicians refer a variety of depressed patients for a repetitive Transcranial Magnetic Stimulation (rTMS) treatment. It has been suggested that personality features such as Harm Avoidance (HA) and self-directedness (SD) might provide some guidance for a classical antidepressant treatment outcome. However, to date no such research has been performed in rTMS treatment paradigms. In this open study, we wanted to examine whether these temperament and character scores in particular would predict clinical outcome in refractory unipolar depressed patients when a typical high-frequency (HF)-rTMS treatment protocol is applied. Thirty six unipolar right-handed antidepressant-free treatment resistant depressed (TRD) patients, all of the melancholic subtype, received 10 HF-rTMS sessions applied to the left dorsolateral prefrontal cortex (DLPFC). All patients were classified as at least stage III TRD and were assessed with the Temperament and Character Inventory (TCI) before a HF-rTMS treatment. Only the individual scores on SD predicted clinical outcome. No other personality scales were found to be a predictor of this kind of application. Our results suggest that refractory MDD patients who score higher on the character scale SD may be more responsive to the HF-rTMS treatment.
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Affiliation(s)
- Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.
| | - Stefanie Desmyter
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Romain Duprat
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Dirk Van Denabbeele
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Hannelore Tandt
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Gilbert M D Lemmens
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Myriam Vervaet
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Kees van Heeringen
- Department of Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, Ghent, Belgium
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20
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Altunayoglu Cakmak V, Gazioglu S, Can Usta N, Ozkorumak E, Ayar A, Topbas M, Boz C. Evaluation of temperament and character features as risk factors for depressive symptoms in patients with restless legs syndrome. J Clin Neurol 2014; 10:320-7. [PMID: 25324881 PMCID: PMC4198713 DOI: 10.3988/jcn.2014.10.4.320] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 05/10/2014] [Accepted: 05/13/2014] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Restless legs syndrome (RLS) is a common sleep-related movement disorder that is frequently associated with psychological disturbances. Personality traits are of considerable importance with respect to coping with chronic illness and disease vulnerability. This study assessed the temperament and character traits of RLS patients using an approach that involves the psychobiological model of personality. METHODS The personality features of 65 newly diagnosed and untreated RLS patients with no neurological or psychiatric diseases and 109 healthy controls were determined using the Temperament and Character Inventory and compared using covariance analyses. The International RLS Study Group Severity Scale was used to assess the severity of the RLS symptoms, and the Beck Depression Inventory was used to assess the presence and severity of depressive symptoms. RESULTS RLS patients scored significantly higher than healthy controls on the temperament dimension of harm avoidance (HA, p=0.02) and significantly lower on self-directedness (SD, p=0.001). No significant difference was observed in terms of the temperament dimension of novelty seeking (p=0.435). HA scores were significantly correlated with the BDI score but not with the RLS severity or duration. CONCLUSIONS High HA and low SD scores are the main characterizing personality features of RLS patients. These personality dimensions may be among the factors predisposing patients to development of the depressive symptoms that are frequently associated with RLS.
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Affiliation(s)
| | - Sibel Gazioglu
- Department of Neurology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Nuray Can Usta
- Department of Neurology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Evrim Ozkorumak
- Department of Psychiatry, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Ahmet Ayar
- Department of Physiology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Murat Topbas
- Department of Public Health, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Cavit Boz
- Department of Neurology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
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Tomita T, Ishioka M, Kaneda A, Sugawara N, Nakagami T, Nakamura K, Yasui-Furukori N. An investigation of temperament and character inventory items for predicting the response to paroxetine treatment in patients with major depressive disorder. J Affect Disord 2014; 165:109-13. [PMID: 24882186 DOI: 10.1016/j.jad.2014.04.076] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 04/25/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous studies have reported associations between Temperament and Character Inventory (TCI) dimension scores and the response to treatment in patients with major depressive disorder (MDD). We aimed to determine which TCI items could predict the response to treatment with paroxetine in patients with MDD. METHODS Seventy-three patients were enrolled in this study. The participants were treated with 10-40mg/day of paroxetine for six weeks; they then completed the TCI. The Montgomery-Asberg Depression Rating Scale (MADRS) was used to evaluate the patients. The participants were divided into two groups (responders and non-responders). We used a chi-squared test to identify the 10 items with the strongest association with treatment response from among all 240 items on the TCI, and we used a multiple logistic regression analysis to confirm the validity of these 10 items. RESULTS Among the TCI dimension scores, only the C score differed significantly between the two groups. We analyzed 10 models using each of the 10 best items. All the models significantly predicted treatment response. The TCI dimensions model also significantly predicted treatment response, but its predictive value was lower than those of the other 10 models. LIMITATIONS The responders included the early responders. The results lacked information about responders whose responses were not predicted by the logistic regression models and TCI items. CONCLUSIONS Some TCI items showed significant associations with the response to paroxetine treatment in the patients with MDD. Treatment response in patients with MDD may be predicted using only 10 items from the TCI.
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Affiliation(s)
- Tetsu Tomita
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Masamichi Ishioka
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Ayako Kaneda
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Norio Sugawara
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Taku Nakagami
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Kazuhiko Nakamura
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan
| | - Norio Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki 036-8562, Japan.
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Baeken C, Bossuyt A, De Raedt R. Dorsal prefrontal cortical serotonin 2A receptor binding indices are differentially related to individual scores on harm avoidance. Psychiatry Res 2014; 221:162-8. [PMID: 24412555 DOI: 10.1016/j.pscychresns.2013.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 11/20/2013] [Accepted: 12/19/2013] [Indexed: 01/15/2023]
Abstract
Although the serotonergic system has been implicated in healthy as well as in pathological emotional states, knowledge about its involvement in personality is limited. Earlier research on this topic suggests that post-synaptic 5-HT2A receptors could be involved in particular in frontal cortical areas. In drug-naïve healthy individuals, we examined the relationship between these 5-HT2A receptors and the temperament dimension harm avoidance (HA) using 123I-5-I-R91150 single photon emission computed tomography (SPECT). HA is a personality feature closely related to stress, anxiety and depression proneness, and it is thought to be mediated by the serotonergic system. We focused on the prefrontal cortices as these regions are frequently implicated in cognitive processes related to a variety of affective disorders. We found a positive relationship between dorsal prefrontal cortical (DPFC) 5-HT2A receptor binding indices (BI) and individual HA scores. Further, our results suggest that those individuals with a tendency to worry or to ruminate are particularly prone to display significantly higher 5-HT2A receptor BI in the left DPFC. Although we only examined psychologically healthy individuals, this relationship suggests a possible vulnerability for affective disorders.
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Affiliation(s)
- Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium; Department of Psychiatry, University Hospital UZBrussel, Brussels, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.
| | - Axel Bossuyt
- Department of Nuclear Medicine, University Hospital UZBrussel, Brussels, Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Paavonen V, Kampman O, Illi A, Viikki M, Setälä-Soikkeli E, Leinonen E. A cluster model of temperament as an indicator of antidepressant response and symptom severity in major depression. Psychiatry Investig 2014; 11:18-23. [PMID: 24605119 PMCID: PMC3942547 DOI: 10.4306/pi.2014.11.1.18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 06/14/2013] [Accepted: 07/03/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Not enough is known about which patients suffering from major depressive disorder benefit from antidepressant drug treatment. Individual temperament is relatively stable over a person's lifespan and is thought to be largely biologically predefined. We assessed how temperament profiles are related to depression and predict the efficacy of antidepressant treatment. METHODS We recruited one hundred Finnish outpatients (aged 19 to 72) suffering from major depressive disorder, of whom 86 completed the 6-week study. We assessed their temperament features with the Temperament and Character Inventory and used cluster analysis to determine the patient's temperament profile. We also categorized the patients according to the vegetative symptoms of major depressive disorder. RESULTS There was an association between skewed temperament profile and severity of major depressive disorder, but the temperament profiles alone did not predict antidepressant treatment response. Those with higher baseline vegetative symptoms score had modest treatment response. Our model with baseline Montgomery Åsberg Depression Rating Scale (MADRS) vegetative symptoms, age and temperament clusters as explanatory variables explained 20% of the variance in the endpoint MADRS scores. CONCLUSION The temperament clusters were associated both with severity of depression and antidepressive treatment response of depression. The effect of the temperament profile alone was modest but, combined with vegetative symptoms of depression, their explanatory power was more marked suggesting that there could be an association of these two in the biological basis of MDD.
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Affiliation(s)
- Vesa Paavonen
- University of Tampere School of Medicine, Tampere, Finland
- Tampere University Hospital, Department of Psychiatry, Tampere, Finland
| | - Olli Kampman
- University of Tampere School of Medicine, Tampere, Finland
- Seinäjoki Hospital District, Department of Psychiatry, Seinäjoki, Finland
| | - Ari Illi
- University of Tampere School of Medicine, Tampere, Finland
- Satakunta Hospital District, Department of Psychiatry, Harjavalta, Finland
| | - Merja Viikki
- University of Tampere School of Medicine, Tampere, Finland
- Tampere Mental Health Centre, Tampere, Finland
| | | | - Esa Leinonen
- University of Tampere School of Medicine, Tampere, Finland
- Tampere University Hospital, Department of Psychiatry, Tampere, Finland
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Aukst Margetić B, Kukulj S, Šantić Ž, Jakšić N, Jakovljević M. Predicting depression with temperament and character in lung cancer patients. Eur J Cancer Care (Engl) 2013; 22:807-14. [DOI: 10.1111/ecc.12080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2013] [Indexed: 12/31/2022]
Affiliation(s)
- B. Aukst Margetić
- Department of Psychiatry; University Hospital Center Zagreb; Zagreb Croatia
| | - S. Kukulj
- Department of Pulmonary Diseases Jordanovac; University Hospital Center Zagreb; Zagreb Croatia
| | - Ž. Šantić
- University School of Medicine Mostar; Mostar Bosnia and Herzegovina
| | - N. Jakšić
- Department of Psychiatry; University Hospital Center Zagreb; Zagreb Croatia
| | - M. Jakovljević
- Department of Psychiatry; University Hospital Center Zagreb; Zagreb Croatia
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Personality traits as risk factors for treatment-resistant depression. PLoS One 2013; 8:e63756. [PMID: 23717477 PMCID: PMC3661718 DOI: 10.1371/journal.pone.0063756] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/04/2013] [Indexed: 11/19/2022] Open
Abstract
Background The clinical outcome of antidepressant treatment in patients with major depressive disorder (MDD) is thought to be associated with personality traits. A number of studies suggest that depressed patients show high harm avoidance, low self-directedness and cooperativeness, as measured on the Temperament and Character Inventory (TCI). However, the psychology of these patients is not well documented. Methods Psychological evaluation using Cloninger’s TCI, was performed on treatment-resistant MDD patients (n = 35), remission MDD patients (n = 31), and age- and gender-matched healthy controls (n = 174). Results Treatment-resistant patients demonstrated high scores for harm avoidance, and low scores for reward dependence, self-directedness, and cooperativeness using the TCI, compared with healthy controls and remission patients. Interestingly, patients in remission continued to show significantly high scores for harm avoidance, but not other traits in the TCI compared with controls. Moreover, there was a significant negative correlation between reward dependence and harm avoidance in the treatment-resistant depression cohort, which was absent in the control and remitted depression groups. Conclusions This study suggests that low reward dependence and to a lesser extent, low cooperativeness in the TCI may be risk factors for treatment-resistant depression.
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Abstract
BACKGROUND In major depression, one of the candidate genes possibly affecting the risk and severity of symptoms has been found to be tryptophan hydroxylase (TPH1). Variation in treatment response to antidepressive agents according to TPH1 genotype has also been found in several studies. However, the relationship between temperament and TPH1 genotype in major depression is poorly understood, as only one study has been published so far. There are no earlier studies on the interaction between temperament traits, antidepressive medication response and TPH1 genotype. This interaction was studied in 97 subjects with major depression treated for six weeks with selective serotonine reuptake inhibitors. METHODS Temperament dimensions Harm Avoidance (HA), Novelty Seeking (NS), Reward Dependence (RD) and Persistence (P) scores at baseline (1) and endpoint (2) were rated with the Temperament and Character Inventory (TCI) and compared between TPH1 A218C genotypes. Multivariate analysis of co-variance (MANCOVA) was used to analyze the interaction between the TPH1 genotype, treatment response and the different temperament dimensions at baseline and endpoint. In the analysis model, treatment response was used as a covariate and TPH1 genotype as a factor. A post hoc analysis for an interaction between remission status and TPH1 A218C genotype at endpoint HA level was also performed. RESULTS The number of TPH1 A-alleles was associated with increasing levels in NS1 and NS2 scores and decreasing levels in HA1 and HA2 scores between TPH1 A218C genotypes. In the MANCOVA model, TPH1 genotype and treatment response had an interactive effect on both HA1 and HA2 scores, and to a lesser degree on NS2 scores. Additionally, an interaction between remission status and TPH1 A218C genotype was found to be associated with endpoint HA score, with a more marked effect of the interaction between CC genotype and remission status compared to A-allele carriers. CONCLUSIONS Our results suggest that in acute depression TPH1 A218C polymorphism and specifically the CC genotype together with the information on remission or treatment response differentiates between different temperament profiles and their changes.
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Ekinci O, Albayrak Y, Ekinci AE. Temperament and character in euthymic major depressive disorder patients: the effect of previous suicide attempts and psychotic mood episodes. Psychiatry Investig 2012; 9:119-26. [PMID: 22707961 PMCID: PMC3372558 DOI: 10.4306/pi.2012.9.2.119] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 12/14/2011] [Accepted: 12/16/2011] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine personality traits of patients with major depressive disorder and explore the possible connections between personality and clinical and sociodemographic variables. METHODS The sociodemographic and clinical properties of 80 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their personality was evaluated by using Temperament and Character Inventory and results were compared with 80 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to TCI scores. RESULTS Remitted depressive patients scored significantly lower on on self-directedness and higher on harm avoidance than HC. Previous suicide attempts had a main effect only on harm avoidance while previous psychotic mood episodes were significantly associated with novelty seeking, self-directedness and cooperativeness. With respect to numeric clinical variables, only duration of illness was significantly and negatively correlated with NS and RD scores. CONCLUSION Patients with euthymic major depressive disorder may have significantly different personality traits than the normal population, and patients with different clinical and sociodemographic characteristics may show different personality patterns. In addition, assessment of major depressed patients by means of the Temperament and Character Inventory may be helpful to get a deeper insight into those personality traits underlying suicidality and the emergence of psychotic mood episode.
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Affiliation(s)
- Okan Ekinci
- Department of Psychiatry, Yozgat State Hospital, Yozgat, Turkey.
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