Presence of neuroticism and antidepressant remission rates in late-life depression: results from the Neurobiology of Late-Life Depression (NBOLD) study.
Presence of neuroticism and antidepressant remission rates in late-life depression: results from the Neurobiology of Late-Life Depression (NBOLD) study.
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DOI：
10.1017/s1041610217002551
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发表时间：
2018-07
影响因子：
7
通讯作者：
Manning KJ
中科院分区：
文献类型：
--
作者：
Steffens DC;Wu R;Grady JJ;Manning KJ
老年人的神经质很常见，但研究不足，特别是其对抑郁症治疗结果的影响。我们假设，在舍曲林治疗的老年抑郁症患者中，高神经质的存在与较低的12周缓解率相关。在这项纵向队列研究中，43名抑郁症老年人完成了修订的NEO人格量表（NEO PI-R）。研究精神病学家在基线时使用蒙哥马利斯伯格抑郁评定量表（MADRS）和累积疾病评定量表（CIRS，一种医疗负担的测量方法），并在每次临床访视时使用MADRS。所有受试者开始开放标签舍曲林治疗，并随访超过12周，临床指示灵活的剂量和选择转换抗抑郁药。我们使用回归分析来检查与抑郁症12周缓解（MADRS评分< 8）和最终MADRS评分相关的因素。我们发现，较高的总神经质（比值比（OR）= 0.963，95%置信区间（CI）= 0.928-1.000）和神经质子量表，压力脆弱性（OR = 0.846，95% CI = 0.728-0.983），与意向治疗组和舍曲林完成者缓解的可能性较低。在控制基线MADRS和CIRS评分后，结果仍具有显著性。总之，人格评估，特别是神经质特征，对于晚年抑郁症的管理可能很重要。未来的研究应该确定，如果抑郁症患者神经质高可能受益于心理治疗，重点是情绪调节和压力管理。
Neuroticism in older adults is common yet understudied, particularly its effects on depression treatment outcomes. We hypothesized that presence of high neuroticism would be associated with lower 12-week remission rates in older depressed sertraline-treated patients. In this longitudinal cohort study, 43 depressed older adults completed the Revised NEO Personality Inventory (NEO PI-R). A study psychiatrist administered the Montgomery Ǻsberg Depression Rating Scale (MADRS), and the Cumulative Illness Rating Scale (CIRS, a measure of medical burden) at baseline, and the MADRS at each clinical visit. All subjects began open-label sertraline treatment and were followed over 12 weeks with clinically indicated flexible dosing and an option to switch antidepressants. We used regression analyses to examine factors related to 12-week remission of depression (MADRS score < 8) and final MADRS score. We found that higher total neuroticism (odds ratio (OR) = 0.963, 95% confidence interval (CI) = 0.928–1.000) and a neuroticism subscale, stress vulnerability (OR = 0.846, 95% CI = 0.728–0.983), were associated with lower likelihood of remission among both the intention-to-treat group and sertraline completers. Findings remained significant after controlling for baseline MADRS and CIRS score. In conclusion, assessment of personality, particularly features of neuroticism, may be important in management of late-life depression. Future studies should determine if depressed patients high in neuroticism may benefit from psychotherapy focusing on emotional regulation and stress management.