Personality and social support as predictors of first and recurrent episodes of depression

Prospective Associations Between Personality Traits and Major Depressive Disorder Symptom Severity: The Mediating Role of Illness Representations

Major depressive disorder (MDD) patients' personality traits and illness representations are linked to MDD severity. However, the associations between personality and illness representations in MDD and the mediating role of illness representations between personality and MDD severity have not been investigated. This study aimed to prospectively investigate the aforementioned associations and the possible mediating role of illness representations between personality and MDD severity. One hundred twenty-five patients with a MDD diagnosis, aged 48.18 ± 13.92 (84% females), participated in the study. Personality traits were measured with the Traits Personality Questionnaire at baseline. Illness representations were measured with the Illness Perception Questionnaire-Mental Health about five months later (mean = 5.08 ± 1.14 months). MDD severity was measured about 10 months after the baseline assessment (mean = 9.53 ± 2.36 months) with the Beck Depression Inventory. SPSS 29 and AMOS 27 were used to conduct correlational and parallel mediation analyses. According to the results, Neuroticism was positively and Extraversion was negatively linked to MDD severity. Negative MDD impact representations fully mediated these associations. Neuroticism and Extraversion are linked to future MDD severity through patients' representations of MDD's impact. Restructuring maladaptive representations about MDD's impact can be a promising way to reduce symptom severity in patients with high Neuroticism and low Extraversion levels.

Eating Behaviors and Physical Activity versus the Big Five Personality Traits in Women with a Hereditary Predisposition to Breast or Ovarian Cancer

The Big Five personality traits-neuroticism, extroversion, openness to experience, agreeableness, and conscientiousness-represent continuous, individual features that affect a number of vital health aspects, including morbidity, self-reported health status, or lifestyle. The aim of this study was to analyze the relationship between the eating behaviors and engagement in physical activity of women with a hereditary predisposition to breast or ovarian cancer and the Big Five personality traits. A total of 357 women, participants of 'The National Program for Families With Genetic/Familial High Risk for Cancer', were included in the study. In the healthy group, the following statistically significant predictors were found in variables: agreeableness-meal frequency (β = 0.151; p = 0.030); neuroticism-consumption of fruits and vegetables (β = -0.177; p = 0.016) and cereal products (β = -0.223; p = 0.002); openness to experience-consumption of plant-based fats (β = 0.141; p = 0.034) and physical activity (β = 0.153; p = 0.021). In the cancer group, the frequency of dairy consumption (β = 0.286; p = 0.003) and physical activity (β = 0.370; p = 0.000) were found to be statistically significant predictors for the openness to experience variable. Neuroticism is associated with less frequent consumption of fresh fruits and vegetables as well as cereal products. Openness to experience was more often linked with a higher frequency of dairy consumption, plant-based fats, and physical activity. Women with breast or ovarian cancer and a higher openness to experience consumed dairy and engaged in physical activity more often than their peers with the remaining personality traits.

Determinants of Depressive Symptoms Among Patients with Rheumatoid Arthritis in China: A Structural Equation Model

Background

This study aimed to examine how personality traits, social support and clinical features including pain, disease activity, functional status, sleep quality, and fatigue influence on depressive symptoms in Chinese rheumatoid arthritis (RA) patients.

Methods

This study was conducted from November, 2022 to June, 2023 among Chinese RA patients. Pain, disease activity, functional status, sleep quality, fatigue, social support, personality traits, and depressive symptoms were assessed. The following relationships among three hypotheses were analyzed by structural equation model (SEM): H1: clinical features have a direct effect on depressive symptoms; H2: personality traits might work as a mediator between clinical features and depression; H3: social support is related to depressive symptoms, being a direct effect or an indirect effect through clinical features or personality traits.

Results

The final model including 326 RA patients presented a good fit (χ2=103, χ2/df=1.69; GFI=0.96; AGFI=0.93; CFI=0.97; TLI=0.96; RMSEA=0.046). Clinical features had a total effect of 0.59 on depressive symptoms, of which β=0.33 (P=0.013) was an indirect effect through personality traits, indicating a mediating influence between this relationship; moreover, there was a significant direct association between clinical features and depressive symptoms (β=0.26; P=0.022). Personality traits (β=-0.65; P<0.001) had a much stronger relation with depressive symptoms than with clinical features. Social support had a total effect of 0.81 on personality traits, being a direct effect of β=0.52 (P<0.001) and an indirect effect of β=0.29 (P<0.001) through clinical features. The final proposed model explained 77% of the variance of depressive symptoms.

Conclusion

Personality traits had a considerable influence upon depressive symptoms, while social support seemed to have a major effect on personality traits. It is necessary to apply comprehensive assessment and interventions of patients' personality traits, clinical features, as well as social support, which could optimize their mental health.

Personality traits as risk factors for relapse or recurrence in major depression: a systematic review

Background

Major depressive disorder (MDD) is highly recurrent. Identifying risk factors for relapse in depression is essential to improve prevention plans and therapeutic outcomes. Personality traits and personality disorders are widely considered to impact outcomes in MDD. We aimed to evaluate the role of personality aspects in the risk of relapse and recurrence in MDD.

Method

A PROSPERO-registered systematic review was conducted using Medline, Embase, PsycINFO, Web of Science and CINAHL as data sources, together with hand searching of four journals over the five years till 2022. There was independent abstract selection, quality assessment and data extraction from each study.

Results

Twenty two studies me t eligibility criteria involving 12,393 participants. Neurotic personality features are significantly associated with the risk of relapse and recurrence of depression, though the data is not uniform. There is some, though limited, evidence that borderline, obsessive-compulsive and dependent personality traits or disorders increase the risk for relapse in depression.

Limitations

The small number, in addition to the methodological heterogeneity of the included studies, did not allow further analysis, such as meta-analysis.

Conclusion

People with high neuroticism and dependent personality traits, borderline personality disorder or obsessive-compulsive personality disorder, compared to those without, may be at a higher risk of experiencing relapse or recurrence of MDD. Specific and targeted interventions may potentially reduce relapse and recurrence rates in these groups and could improve outcomes.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=235919, identifier: CRD42021235919.

Psychological resilience and related influencing factors in patients diagnosed with major depressive disorder in remission: A cross-sectional study

WHAT IS KNOWN ON THE SUBJECT?: Recurrence is common in patients diagnosed with major depressive disorder (MDD). Psychological resilience has been shown to be a protective factor against recurrence of depression. It has important clinical nursing significance to analyse the influencing factors of psychological resilience in major depressive disorder in remission (MDDR) patients. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with MDDR. We found the education levels, personal monthly income, social support, well-being and self-efficacy were influencing factors of psychological resilience in patients diagnosed with MDDR. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression. Nurses should strengthen the nursing of patients with <12 years of education, and patients with personal monthly income less than 5000 RMB. In addition, nurses should cultivate patients' awareness of social support and identity, cultivate their ability to strive for social support, cultivate interpersonal skills and positive emotional experience to improve subjective well-being and carry out self-efficacy training to improve psychological resilience by enhancing patients' internal protective factors.

ABSTRACT

AIM: Psychological resilience is closely related to recurrence of depression. There are few previous studies on the influencing factors of psychological resilience in patients diagnosed with major depressive disorder in remission (MDDR). Here, we investigated the current status of resilience in patients diagnosed with MDDR and its influencing factors.

METHODS

A descriptive cross-sectional study was conducted from June 2019 to April 2021. One hundred and forty-two patients diagnosed with MDDR were recruited from the Department of Psychiatry and Psychology of the General Hospital of Northern Theater Command. Demographic information, social support, well-being, self-efficacy and psychological resilience were collected using self-reported questionnaires.

RESULTS

The psychological resilience of MDDR patients was lower than that of the healthy Chinese adults in China. Multiple logistic regression analysis showed that education, personal monthly income, social support, well-being and self-efficacy were associated with psychological resilience. Receiver operating characteristic (ROC) curve analysis further confirmed that social support, well-being and self-efficacy were associated with psychological resilience.

CONCLUSION

The psychological resilience of MDDR patients was lower than that of the general population in China. The education levels, personal monthly income, social support, well-being and self-efficacy were influencing factors of psychological resilience.

IMPLICATIONS FOR PRACTICE

According to the factors affecting the psychological resilience of patients diagnosed with MDDR, targeted clinical nursing is helpful to prevent the recurrence of depression.

Social connectedness as a determinant of mental health: A scoping review

Public health and epidemiologic research have established that social connectedness promotes overall health. Yet there have been no recent reviews of findings from research examining social connectedness as a determinant of mental health. The goal of this review was to evaluate recent longitudinal research probing the effects of social connectedness on depression and anxiety symptoms and diagnoses in the general population. A scoping review was performed of PubMed and PsychInfo databases from January 2015 to December 2021 following PRISMA-ScR guidelines using a defined search strategy. The search yielded 66 unique studies. In research with other than pregnant women, 83% (19 of 23) studies reported that social support benefited symptoms of depression with the remaining 17% (5 of 23) reporting minimal or no evidence that lower levels of social support predict depression at follow-up. In research with pregnant women, 83% (24 of 29 studies) found that low social support increased postpartum depressive symptoms. Among 8 of 9 studies that focused on loneliness, feeling lonely at baseline was related to adverse outcomes at follow-up including higher risks of major depressive disorder, depressive symptom severity, generalized anxiety disorder, and lower levels of physical activity. In 5 of 8 reports, smaller social network size predicted depressive symptoms or disorder at follow-up. In summary, most recent relevant longitudinal studies have demonstrated that social connectedness protects adults in the general population from depressive symptoms and disorders. The results, which were largely consistent across settings, exposure measures, and populations, support efforts to improve clinical detection of high-risk patients, including adults with low social support and elevated loneliness.

The diagnostic and predictive potential of personality traits and coping styles in major depressive disorder

BACKGROUND

Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals.

METHODS

Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals.

RESULTS

Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD.

CONCLUSIONS

Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.

Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research

BACKGROUND

The Netherlands Study of Depression and Anxiety (NESDA; N_baseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders.

METHODS

A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders.

RESULTS

All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders.

CONCLUSION

NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.

The dyadic effects of personality traits on depression in advanced lung cancer patients and caregivers: The mediating role of acceptance of illness

OBJECTIVE

This study aimed to explore the intrapersonal and interpersonal effects of three personality traits-neuroticism, extraversion and conscientiousness-on depression and examine whether acceptance of illness mediates the actor and partner effects in advanced lung cancer patients and caregivers using the Actor-Partner Interdependence Mediation Model (APIMeM).

METHODS

A total of 304 dyads of advanced lung cancer patients and caregivers were studied. Personality traits, acceptance of illness and depression were measured using 44-item Big Five Inventory, the Acceptance of Illness (AIS) scale and the Patient Health Questionnaire (PHQ-9).

RESULTS

The APIMeMs suggested that there were significant actor-actor effects of the three personality traits on depression through their own acceptance of illness. Additionally, significant actor-partner effects of neuroticism and extraversion on depression were also found. Specifically, patients' neuroticism was negatively related to their own acceptance of illness, which increased caregivers' depression, and caregivers' higher extraversion was related to their own higher acceptance of illness, which reduced patients' depression. Furthermore, a significant partner-actor effect was only found in the neuroticism model. Patients' neuroticism was negatively related to caregivers' acceptance of illness, which increased caregivers' depression.

CONCLUSION

The three personality traits had both interpersonal and intrapersonal effects on depression in advanced lung cancer patient-caregiver dyads, and acceptance of illness played an important mediating role in these relationships.

Association between social network characteristics and prevalent and incident depression: The Maastricht Study

AIMS

Social network characteristics may provide a novel non-pharmaceutical target for the prevention of depression. We investigated the temporal association of a broad range of structural and functional social network characteristics with incident depressive symptoms over 5 years of follow-up.

METHODS

We used data from The Maastricht Study, a population-based prospective cohort study (n=2,465, mean age 59.8±8.1 years, 49.1% women, 11,585 person-years of follow-up). Social network characteristics were assessed through a name generator questionnaire. Clinically relevant depressive symptoms (9-item Patient Health Questionnaire score≥10) were assessed at baseline and annually. We used multivariable logistic and Cox regression analyses, adjusted for sociodemographic, lifestyle and cardiovascular risk factors.

RESULTS

In cross-sectional analyses less emotional support for discomfort and with important decisions, and less informational support were associated with prevalent depressive symptoms (OR[95%CI] 1.19 [1.01-1.40]; 1.22 [1.05-1.43], and 1.20 [1.04-1.39], respectively). Every fewer 10% of family members was associated with prevalent depressive symptoms (1.11 [1.01-1.23]). In longitudinal analyses, less emotional support on important decisions was also associated with higher risk of incident depressive symptoms (HR[95%CI] 1.13 [1.03-1.25]). In addition, every fewer 10% of the network that was a family member was associated with a higher hazard of incident depressive symptoms (1.07 [1.01-1.13]).

CONCLUSIONS

This study shows that less emotional support and fewer family members in the network were associated with higher risk of both prevalent and incident depression. The importance of emotional support and the role that family plays should be considered in treatment and prevention of depression.

Prevalence and Associated Factors of Depressive Disorder in Caregivers of Individuals With Parkinson Disease

OBJECTIVE

Parkinson disease (PD) is a debilitating neurodegenerative disease. Caring for an individual with PD can have a variety of negative physical and psychological effects on caregivers which may challenge their ability to continue in their caretaking role. The aim of this study was to assess the prevalence and associated factors of depressive disorders in caregivers of individuals with PD using standardized instruments.

METHODS

This study used a cross-sectional design with consecutive sampling. Study participants were recruited from the neurological ward or neurological outpatient clinic of a medical center from August 2018 to July 2019. Caregivers of persons with PD were enrolled and assessed using the Mini International Neuropsychiatric Interview, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Beck Hopelessness Scale, Brief Fatigue Inventory, Connor-Davidson Resilience Scale, and Big Five Inventory-10.

RESULTS

Of the 162 caregivers that completed the study, 67.3% (n = 109) were females. The most common psychiatric diagnosis was depressive disorder (11.1%), followed by insomnia disorder (7.4%) and anxiety disorder not otherwise specified (4.3%); 28% of the caregivers had a psychiatric diagnosis. Using logistic regression analysis, it was found that duration of caregiving (odds ratio [OR] = 1.28; 95% CI, 1.05-1.58), severity of anxiety (OR = 1.86; 95% CI, 1.36-2.53), and severity of fatigue (OR = 1.08; 95% CI, 1.01-1.16) were 3 significant associated factors for the development of depression.

CONCLUSION

Depression was the most prevalent psychiatric diagnosis in caregivers of people with PD. Early diagnosis of these caregivers is crucial to the offering of suitable support and treatment and might improve caregivers' quality of life.

Psychological factors for the onset of depression: a meta-analysis of prospective studies

OBJECTIVES

A comprehensive overview of the evidence for factors derived from leading psychological theories of the onset of major depressive disorder (MDD) that underpin psychological interventions is scarce . We aimed to systematically investigate the prospective evidence for factors derived from the behavioural, cognitive, diathesis-stress, psychodynamic and personality-based theories for the first onset of MDD.

DESIGN

Systematic review and meta-analysis.

METHODS

Databases PubMed, PsycINFO, Cochrane and Embase and published articles were systematically searched from inception up to August 2019. Prospective, longitudinal studies that investigated theory-derived factors before the first onset of MDD, established by a clinical interview, were included. Screening, selection and data extraction of articles were conducted by two screeners. The Grading of Recommendations Assessment, Development and Evaluation criteria were used to estimate level of confidence and risk of bias. Meta-analysis was conducted using random-effects models and mixed-method subgroup analyses.

PRIMARY AND SECONDARY OUTCOME MEASURES

Effect size of a factor predicting the onset of MDD (OR, risk ratio or HR).

RESULTS

From 42 133 original records published to August 2019, 26 studies met the inclusion criteria. Data were only available for the cognitive (n=6585) and personality-based (n=14 394) theories. Factors derived from cognitive theories and personality-based theories were related to increased odds of MDD onset (pooled OR=2.12, 95% CI: 1.12 to 4.00; pooled OR=2.43, 95% CI: 1.41 to 4.19). Publication bias and considerable heterogeneity were observed.

CONCLUSION

There is some evidence that factors derived from cognitive and personality-based theories indeed predict the onset of MDD (ie, dysfunctional attitudes and negative emotionality). There were no studies that prospectively studied factors derived from psychodynamic theories and not enough studies to examine the robust evidence for behavioural and diathesis-stress theories. Overall, the prospective evidence for psychological factors of MDD is limited, and more research on the leading psychological theories is needed.

PROSPERO REGISTRATION NUMBER

CRD42017073975.

Locus of control, personality and depression symptoms in cancer: Testing a moderated mediation model

OBJECTIVE

To investigate the mediator role of locus of control on the relationship between the Big Five personality traits and the manifestation of depression symptoms in cancer outpatients.

METHOD

Participants consisted of 220 cancer outpatients (138 women and 82 men), evaluated individually at the hospital waiting room. The measures applied were as follows: The NEO-Five Factor Inventory (NEO-FFI), Multidimensional Health Locus of Control (MHLC) Scale and Hospital Anxiety and Depression Scale (HADS).

RESULTS

The factor structure of NEO-FFI was reexamined. A moderated mediation model was found for the powerful others external locus of control (LOC), depression symptoms and extraversion and conscientiousness traits across sex.

CONCLUSIONS

Extraverted individuals can seek for others' support and use their attachments to find someone to guide them; conscientious patients can rely on their physician and follow every rule and orientation demanded, temporarily delegating to others the responsibility for their lives. All these strategies can help to decrease symptoms of depression. The perception of control can be taught, and it may be specifically relevant for mental health and in the performance of health behaviours.

Why some siblings thrive whereas others struggle: A within-family study on recollections of childhood parental bonding and current adult depressive and anxiety symptoms

BACKGROUND

Brothers and sisters growing up together share a large proportion of their genes and rearing environment. However, some siblings thrive whereas others struggle. This study investigated family-wide childhood bonding experiences with mother and father, in addition to individual-specific recollections, in relation to current depressive and anxiety symptom levels in adulthood. We examined whether extraversion and internal locus of control (iLoC) had a protective effect in this.

METHODS

The sample consisted of 256 families with at least one lifetime depressed or anxious person (N = 596; ages 20-78). Multilevel modeling with cross-level interactions was used.

RESULTS

Adult siblings showed moderate to high agreement in their childhood parental bonding (PB) recollections. Over-and-above the association between individual-specific recollections of PB and adult internalizing symptoms, family-wide poor PB was additionally linked to elevated symptom levels. Within families characterized by poor maternal bonding persons with an iLoC were relatively less anxious (but not less depressed), whereas extraversion was not protective in this context.

LIMITATION

Although evidence exists that poor childhood PB has an impact on (adult) psychopathology, causality cannot be determined and possible recall bias of PB should be noted. Moreover, next to their moderating effects, extraversion and LoC may also act as mediators.

CONCLUSIONS

Our findings extend prior work by demonstrating the importance of siblings' childhood PB experiences next to a person's own recollections when investigating adult internalizing symptoms, while also elucidating individual differences within families.

The correlation analysis between the appearance anxiety and personality traits of the medical staff on nasal and facial pressure ulcers during the novel coronavirus disease 2019 outbreak

Aim

To investigate the psychological status of medical staff with medical device-related nasal and facial pressure ulcers (MDR PUs) during the outbreak of COVID-19, analyse the correlation between their psychological status and personality traits, so as to provide a reference for personalized psychological support.

Design

A total of 207 medical staff who were treating the COVID-19 epidemic from Hunan and Hubei provinces were enrolled in this analytic questionnaire-based study.

Methods

We used these measures: Eysenck Personality Questionnaire Short Scale (EPQ-RSC), Social Appearance Anxiety Scale (SAAS), Positive and Negative Affect Scale (PANAS) and demographic information forms online.

Results

Medical staff wearing protective equipment are particularly susceptible to nasal and facial MDR PUs, which is increasing their social appearance anxiety; neuroticism is significantly related to social appearance anxiety and negative emotion. We should pay more attention to their psychological state, cultivate good personality characteristics and reduce negative emotions, and thereby alleviate their MDR PUs-related appearance anxiety.

Seasonality of mood and affect in a large general population sample

Mood and behaviour are thought to be under considerable influence of the seasons, but evidence is not unequivocal. The purpose of this study was to investigate whether mood and affect are related to the seasons, and what is the role of neuroticism in this association. In a national internet-based crowdsourcing project in the Dutch general population, individuals were invited to assess themselves on several domains of mental health. ANCOVA was used to test for differences between the seasons in mean scores on the Positive and Negative Affect Schedule (PANAS) and Quick Inventory of Depressive Symptomatology (QIDS). Within-subject seasonal differences were tested as well, in a subgroup that completed the PANAS twice. The role of neuroticism as a potential moderator of seasonality was examined. Participants (n = 5,282) scored significantly higher on positive affect (PANAS) and lower on depressive symptoms (QIDS) in spring compared to summer, autumn and winter. They also scored significantly lower on negative affect in spring compared to autumn. Effect sizes were small or very small. Neuroticism moderated the effect of the seasons, with only participants higher on neuroticism showing seasonality. There was no within-subject seasonal effect for participants who completed the questionnaires twice (n = 503), nor was neuroticism a significant moderator of this within-subjects effect. The findings of this study in a general population sample participating in an online crowdsourcing study do not support the widespread belief that seasons influence mood to a great extent. For, as far as the seasons did influence mood, this only applied to highly neurotic participants and not to low-neurotic participants. The underlying mechanism of cognitive attribution may explain the perceived relation between seasonality and neuroticism.

Factors Associated With Depressive Episode Recurrences in Primary Care: A Retrospective, Descriptive Study

Introduction and Objective

The early identification of depressive patients having a poor evolution, with frequent relapses and/or recurrences, is one of the priority challenges in this study of high prevalence mental disorders, and specifically in depression. So, this study aims to analyze the factors that may be associated with an increased risk of recurrence of major depression episodes in patients treated in primary care.

Methods

A retrospective, descriptive study of cases-controls was proposed. The cases consisted of patients who had been diagnosed with major depression and who had presented recurrences (n = 101), in comparison with patients who had experienced a single major depression episode with no recurrence (n = 99). The variables of the study are age at first episode; number of episodes; perception of severity of the depression episode suffered prior to recurrence; number of residual symptoms; physical and psychiatric comorbidity; history of anxiety disorders; family psychiatric history; high incidence of stressful life events (SLEs); and experiences of physical, psychological, or sexual abuse in childhood. The differences of the variables were compared between the case subjects and the control subjects, using the Mann-Whitney, chi-square, and Fisher's U statistics. A multivariate analysis (ordinary logistic regression) was performed.

Results

The average age of those suffering more than one depressive episode is significantly older (5 years), and a higher percentage of subjects who have experienced more than one depressive episode have a history of anxiety disorders. In the multivariate analysis, the variables that obtained a significant value in the logistic regression analysis were age (OR: 1.03; value: 0.007) and having suffered sexual abuse during childhood (OR: 1.64; value: 0.072).

Conclusion

These indicators should be considered by primary care physicians when attending patients suffering from major depression.

Course of depressive symptoms in men and women: differential effects of social, psychological, behavioral and somatic predictors

In this study, we aimed to identify the most important and sex-specific social, psychological, behavioral and somatic predictors of recurrent depressive symptoms. Data was obtained at two measurement points within five years by the Gutenberg Health Study (GHS). Out of N = 12,061 individuals, a sample of 877 (age 52.3 ± 9.9) who reported clinically relevant depressive symptoms at baseline was analyzed. Univariate analyses and multiple logistic regression analyses were conducted. Almost half of participants depressed at baseline also reported depressive symptoms five years later. Sex-stratified multivariate analyses revealed that solely social support remained a significant protective predictor against recurrence of depression in men (OR = 0.93; CI_95% = 0.87-0.99), whereas in women smoking (OR = 1.97; CI_95% = 1.23-3.22), and Type D personality (OR = 1.65; CI_95% = 1.10-2.49) were significant risk factors. However, when analyzing the entire sample, no interaction effect between sex and each predictor turned out to be significant. Only social support was retained as an overall predictive factor. As depressive symptoms recur, depressive vulnerability is established involving personality, health behavior and social factors. Although no significant sex-specific interactions were observed, sex-stratified analyses point out different patterns for relevant predictors of recurrent depressive symptoms in men and women.

Personal networks and associations with psychological distress among young and older adults

OBJECTIVE

The aim of the study was to provide new tests of the argument that aspects of personal networks affect psychological distress and moderate the effects of negative life events, leveraging new, rich data on two different cohorts.

METHOD

The UCNets project measured psychological distress, life events, and various dimensions of personal networks for 673 50- to 70-year old adults and 485 21- to 30-year old adults. The project used stratified random address based sampling for all the older adults. Such sampling, supplemented with Facebook advertisement and referral sampling, yielded the young adult sample. Networks were measured using several name-eliciting questions and several name descriptors.

RESULTS

The findings differed for younger versus older adults. Among young adults, personal network characteristics were not directly associated with, nor did they moderate the effect of negative life events on psychological distress. Unlike younger adults, the presence of supportive network ties, including social companions and emergency helpers, were directly associated with lower distress among older adults, while difficult and demanding ties as well as advisors were directly associated with higher distress. There was limited evidence of buffering among older adults, albeit through the presence of difficult and demanding ties.

CONCLUSIONS

In the current sample, network exchange roles (i.e., specific types of network support and burden) were associated with psychological distress among older adults while other characteristics of the network, including size, multiplexity, and social participation were not. Further, network support may be best positioned to have direct, as opposed to buffering, effects on psychological well-being.

Depressive Symptoms Among Police Officers: Associations with Personality and Psychosocial Factors

Protective psychosocial factors may reduce the risk of stress-related illnesses in policing. We assessed the association between protective factors and depressive symptoms among 242 police officers. Participants were from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (2004-2014). Coping, hardiness, personality traits, and social support were assessed at baseline. Depressive symptoms were measured at baseline and follow-up using the Center for Epidemiologic Studies-Depression (CES-D) scale. The relationship between protective factors and the rate of change in depressive symptoms was assessed using linear regression. Logistic regression evaluated associations between protective factors and new-onset depression. Of participants free of depression at baseline, 23 (10.7%) developed probable depression during the follow-up. Odds of new-onset depression increased with increasing neuroticism (adjusted odds ratio [ORADJ] = 1.22, 95% confidence interval [CI], 1.11-1.35) and passive coping (ORADJ = 2.07, 95% CI, 1.06-4.03). Increasing agreeableness (ORADJ = 0.87, 95% CI, 0.78-0.96) and conscientiousness (ORADJ = 0.90, 95% CI, 0.84-0.98) were associated with decreased odds of new-onset depression. New-onset depression was not significantly associated with other coping subscales, hardiness, or social support. There were no significant associations between protective factors and change in depressive symptom scores. This study suggests certain personality characteristics and passive coping may be associated with increased odds of new-onset depression in police officers.

Loss experiences in old age and their impact on the social network and depression- results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)

BACKGROUND

Loss experiences and bereavement are common among the oldest old. This study aims to investigate the effects of loss experiences and the social network type on depression in old age.

METHODS

As part of the Leipzig Longitudinal Study of the Aged (LEILA 75+), a representative population-based cohort study, 783 persons aged 75+ years were assessed via standardized interviews including the Practitioner Assessment of Network Type Instrument (PANT) and the Center for Epidemiologic Studies-Depression Scale (CES-D). Effects of loss experiences and network type on depression were analysed cross-sectionally (baseline survey) using logistic regressions. Effects over time were analysed longitudinally (follow-up1 and follow-up2) using hybrid techniques.

RESULTS

More than half of the elderly (57%) continuously lived in a restricted network. Only 12.1% lived in an integrated network. Although 30.9% had a change in their network, no significant association with loss experiences was found. Nevertheless, loss experiences (OR 7.56 (1.60-35.72)) and a restricted social network (OR 4.08 (1.52-10.95)) appeared to be the significant predictors of depression.

LIMITATIONS

Our study captures only a selected time window of the individual life and loss experience was only assessed at the time of the baseline survey.

CONCLUSION

Our findings revealed that elderly individuals, who experienced social loss or lived in restricted social networks, were more likely to develop depression compared to individuals who lived in integrated social networks or without loss experiences. The social integration of elderly individuals is an urgent issue that should be addressed in order to reduce depression in old age.

Social Support and Depression in Iranian Cancer Patients: the Role of Demographic Variables

Introduction: Depression is the most frequent mental disorder in cancer patients, which is, unfortunately, less noticeable. Despite extensive researches, we only have scant knowledge about the influence of social support on depression in cancer patients. The aim of this study is to examine the relationship between perceived social support and depression and demographic variables on cancer patients. Methods: This is a descriptive correlational study on two hundred cancer patients in Isfahan, Iran. The study subjects were selected through convenient sampling method and data were collected using questionnaires (demographic questionnaire, Multidimensional Scale of Perceived Social Support (MSPSS) and Beck Depression Scale (BDS). Data were analyzed by SPSS software (Frequency distribution, Chi-Square and Spearman correlation). Results: The findings showed that social support and depression in cancer patients are significantly correlated with each other (r = - 0.785, P <0.001). Furthermore, the findings indicated that there are statistically significant correlations between degrees of education with depression and also between the numbers of children with social support and depression in cancer patients. For all analyses, was considered significant. Conclusion: In conclusion, we suggest that interventions to alleviate depression in cancer patients may be designed with consideration of demographic characteristics especially the level of education and the number of supporters of the patient to increase the quality of life in cancer patients and minimize the negative consequences of cancer diagnosis.

Personality traits and course of symptoms of depression and apathy after stroke: Results of the CASPER study

OBJECTIVE

Post-stroke depression (PSD) and post-stroke apathy (PSA) are both associated with adverse outcome after stroke. This study aimed to examine whether personality traits predict the course of PSD and PSA.

METHODS

In this prospective cohort study, 240 stroke patients completed the NEO Five Factor Inventory, Montgomery-Åsberg Depression Rating Scale, and Apathy Evaluation Scale at 3 months post-stroke. Neuropsychiatric assessment was repeated at 6- and 12-month follow-up after initial testing.

RESULTS

Linear mixed models showed that high neuroticism scores were associated with higher depression levels at baseline, and this association remained stable at follow-up. High extraversion scores and high conscientiousness scores were associated with lower apathy levels at baseline. For neuroticism, a significant interaction with time was found, with higher neuroticism scores at baseline being associated with an increase in apathy scores from 6-month to 12-month follow-up. Prospective analyses showed that high extraversion predicted low apathy levels at 6-month and 12-month follow-up independent of its relations with baseline depression and apathy. High neuroticism predicted high apathy levels at 12-month follow-up, whereas high agreeableness and high openness predicted high apathy levels and low apathy levels, respectively, at 6-month follow-up. None of the personality traits predicted depression scores at follow-up.

CONCLUSION

Personality traits are associated with the development and sustainability of PSD and PSA. The traits associated with PSD and PSA were different, providing support for the independence of these constructs. The findings highlight the importance to take personality traits into account as a potential vulnerability factor for PSD and PSA.

Self-perceived level of competitiveness, tension and dependency and depression risk in the SUN cohort

BACKGROUND

Emerging evidence suggests a possible etiologic role of certain personality traits (not necessary dysfunctional) in the risk of depression, but the longitudinal long-term available evidence is currently scarce. We longitudinally assessed whether 3 common personality traits (competitiveness, tension and dependency) were associated with the risk of depression after a maximum follow-up of 15 years.

METHODS

We assessed 15,604 university graduates free of depression at baseline through a self-administered questionnaire including personality traits. Simple, Likert-type, questions with 11 possible answers ranging from 0 to 10 were used at baseline to assess the 3 personality traits. We compared participants with high scores (7-10) versus those with low scores (0-4). New medical diagnoses of depression during follow-up were used as the outcome.

RESULTS

During a median follow-up of 10.1 y, we prospectively identified 902 new medical diagnoses of depression. The multivariable-adjusted hazard ratios (95% confidence intervals) for depression were 1.85 (1.52-2.24) for participants with higher baseline tension (7-10 versus 0 to 4), P-trend < 0.001; and 1.23 (1.06-1.44) for high versus low baseline dependence levels, P-trend = 0.004. Higher levels of competitiveness were marginally associated with lower risk of depression, with hazard ratio = 0.78 (0.61-1.01), P-trend = 0.105.

CONCLUSION

A simple scoring system of personality traits shows an independent association with the future occurrence of depression. This finding underscores, with now prospective evidence, the importance of personality traits in the aetiology of depression and can provide a clinically useful tool for gathering valid information about depression-related personality traits.

The Relationship Between Personality and Somatic and Psychological Distress: A Comparison of Chinese and Australian Adolescents

The extent to which correlations between personality domains and physical and psychological health generalize cross-culturally is unclear. We compared the strength of associations between the personality domains and somatic and psychological distress in Chinese (N = 2069) and a genetically informative sample of Australian (N = 2936) adolescents. We also examined the genetic and environmental etiology between personality, somatic and psychological distress in an Australian sample of 390 monozygotic twins and 698 dizygotic twins. In both populations, personality was assessed using the Junior Eysenck Personality Questionnaire. Somatic and psychological distress was assessed using the Somatic and Psychological Health Report. We found significant cultural differences in the relationship between adolescents' personality traits and somatic and psychological distress. Extraversion was positively associated with somatic distress in the Chinese but not in Australian adolescents. In the Australian twins, genetic covariation between neuroticism and somatic and psychological distress was stronger compared to the genetic associations between either psychoticism or extraversion with psychological distress.

Personality Profile and Clinical Correlates of Patients With Substance Use Disorder With and Without Comorbid Depression Under Treatment

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.

Association of Personality Profiles with Depressive, Anxiety, and Cancer-related Symptoms in Patients Undergoing Chemotherapy

Background

This study identified latent classes of cancer patients based on Big Five personality dimensions and evaluated for differences in demographic and clinical characteristics, depression, anxiety, and cancer-related symptoms.

Methods

Patients (n=1248) with breast, gastrointestinal, gynecological, or lung cancer completed the Center for Epidemiological Studies-Depression scale, Spielberger State-Trait Anxiety Inventories, NEO-Five Factor Inventory (NEO-FFI), and Memorial Symptom Assessment Scale (MSAS). Latent class profile analysis of NEO-FFI scores was used to identify patient subgroups.

Results

Three latent classes were identified. The "Distressed" class (14.3%) scored highest on neuroticism and lowest on extraversion, agreeableness, and conscientiousness. The "Resilient" class (31.9%) scored lowest on neuroticism and highest on extraversion, agreeableness, and conscientiousness. The "Normative" class (53.8%) was intermediate on all dimensions except openness. Compared to the Resilient class, patients in the Distressed class were younger, less educated, more likely to care for another adult, had more comorbidities, and exercised less. The three classes differed by performance status, marital and employment status, and income, but not by gender, time since diagnosis, or type of prior cancer treatment. The classes differed (Distressed > Normative > Resilient) in depression, anxiety, and cancer symptoms.

Conclusions

Personality is associated with psychological and physical symptoms in cancer patients.

Predictors of new-onset depressive disorders - Results from the longitudinal Finnish Health 2011 Study

BACKGROUND

Identifying risk factors for depression is important for understanding etiological mechanisms and targeting preventive efforts. No prior studies have compared risk factors of dysthymia and major depressive disorder (MDD) in a longitudinal setting.

METHODS

Predictors of new-onset MDD and dysthymia were examined in a longitudinal general population study (Health 2000 and 2011 Surveys, BRIF8901). 4057 persons free of depressive disorders at baseline were followed up for 11 years. DSM-IV MDD and dysthymia were diagnosed with the Composite International Diagnostic Interview.

RESULTS

126 persons (4.4%, 95%CI 3.6-5.2) were diagnosed with MDD or dysthymia at follow-up. Predictors of new-onset depressive disorders were younger age (adjusted OR 0.97, 95%CI 0.95-0.99 per year), female gender (aOR 1.46, 95%CI 1.01-2.12), multiple childhood adversities (aOR 1.76, 95%CI 1.10-2.83), low trust dimension of social capital (aOR 0.58, 95%CI 0.36-0.96 for high trust), baseline anxiety disorder (aOR 2.75, 95%CI 1.36-5.56), and baseline depressive symptoms (aOR 1.65, 95%CI 1.04-2.61 for moderate and aOR 2.49, 95%CI 1.20-5.17 for severe symptoms). Risk factors for MDD were younger age, female gender, anxiety disorder and depressive symptoms, whereas younger age, multiple childhood adversities, low trust, and having 1-2 somatic diseases predicted dysthymia.

LIMITATIONS

We only had one follow-up point at eleven years, and did not collect information on the subjects' health during the follow-up period.

CONCLUSIONS

Persons with subclinical depressive symptoms, anxiety disorders, low trust, and multiple childhood adversities have a higher risk of depressive disorders. Predictors of MDD and dysthymia appear to differ. This information can be used to target preventive efforts and guide social policies.