Temperament predicts clomipramine and desipramine response in major depression

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Abstract

Clinical predictors of drug response in major depression have been weak and inconsistent. Eighty-four patients suffering from a current major depressive episode completed a 6-week double-blind trial of either clomipramine or desipramine. Temperament, as measured by the Tridimensional Personality Questionnaire, accounted for 35% of the variance in treatment outcome, compared with less than 5% predicted by clinical variables. In the more severely depressed patients, temperament predicted nearly 50% of the variance in treatment outcome, which is the first time that such a substantial predictor of drug response has been identified. Within depressed women, temperament also predicted response to different antidepressant drugs. The potential importance of temperament, and the need for replication of these findings is discussed.

References (44)

  • B. Pfohl et al.

    The implications of DSM-III personality disorders for patients with major depression

    J. Affect. Disord.

    (1984)
  • G. Steketee et al.

    Methodological issues in prediction of treatment outcome

    Clin. Psychol. Rev.

    (1992)
  • M. Ansseau et al.

    Compulsive personality as predictor of response to serotonergic antidepressants

    Br. Med. J.

    (1991)
  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders (DSM-III-R)

    (1987)
  • G. Andrews et al.

    Diagnosis, personality and the long-term outcome of depression

    Br. J. Psychiatry

    (1990)
  • E.S. Barratt

    Impulsiveness defined within a systems model of personality

  • C.R. Cloninger et al.

    The empirical structure of psychiatric comorbidity and its theoretical significance

  • C.R. Cloninger et al.

    The tridimensional personality questionnaire: US normative data

    Psychol. Rep.

    (1991)
  • C.R. Cloninger

    A. systematic method for clinical description and classification of personality variants

    Arch. Gen. Psychiatry

    (1987)
  • C.R. Cloninger

    A unified biosocial theory of personality and its role in the development of anxiety states

    Psychiatr. Dev.

    (1986)
  • P. Cooper et al.

    Evaluation of a modified self-report measure of social adjustment

    Br. J. Psychiatry

    (1982)
  • L.R. Derogatis et al.

    SCL-90: An outpatient psychiatric rating scale-preliminary report

    Psychopharmacol. Bull.

    (1973)
  • N.S. Downs et al.

    The relationship of affective illness and personality disorders in psychiatric outpatients

    Ann. Clin. Psychiatry

    (1992)
  • C.F. Duggan et al.

    Does personality predict long-term outcome in depression?

    Br. J. Psychiatry

    (1990)
  • I. Elkin et al.

    National institute of mental health treatment of depression collaborative research program: general effectiveness of treatments

    Arch. Gen. Psychiatry

    (1989)
  • H.J. Eysenck et al.

    Manual of the Eysenck Personality Questionnaire

    (1975)
  • E. Frank et al.

    Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence

    Arch. Gen. Psychiatry

    (1991)
  • M. Hamilton

    A rating scale for depression

    J. Neurol. Neurosurg. Psychiatry

    (1960)
  • M. Hamilton

    The assessment of anxiety by rating

    Br. J. Med. Psychol.

    (1959)
  • J.K. Hsiao et al.

    Monoamine neurotransmitter interactions and the prediction of antidepressant response

    Arch. Gen. Psychiatry

    (1987)
  • R.T. Joffe et al.

    Personality and response to tricyclic antidepressants in depressed patients

    J. Nerv. Ment. Dis.

    (1989)
  • P.R. Joyce et al.

    Predictors of drug response in depression

    Arch. Gen. Psychiatry

    (1989)
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