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Presence of neuroticism and antidepressant remission rates in late-life depression: results from the Neurobiology of Late-Life Depression (NBOLD) study

Published online by Cambridge University Press:  04 December 2017

David C. Steffens ,
Rong Wu ,
James J. Grady  and
Kevin J. Manning
David C. Steffens*
Affiliation:
Departments of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
Rong Wu
Affiliation:
Biostatistics Center, Connecticut Institute for Clinical and Translational Science, University of Connecticut School of Medicine, Farmington, Connecticut, USA
James J. Grady
Affiliation:
Biostatistics Center, Connecticut Institute for Clinical and Translational Science, University of Connecticut School of Medicine, Farmington, Connecticut, USA Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, Connecticut, USA
Kevin J. Manning
Affiliation:
Departments of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
*
Correspondence should be addressed to: David C. Steffens, MD, MHS, Professor and Chair, Department of Psychiatry, UConn Health, 264 Farmington Ave, Farmington, CT 06030-1410, USA. Phone: +860-679-4282; Fax: +860-67-1296. Email: steffens@uchc.edu.
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Abstract

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.

Keywords

depressionneuroticismelderlytreatment
Type
Brief Report
Information
International Psychogeriatrics , Volume 30 , Issue 7: Issue Theme: Benzodiazepines and Hypnotics , July 2018 , pp. 1069 - 1074
Copyright
Copyright © International Psychogeriatric Association 2017 

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