Temperament and character influence on depression treatment outcome

Martina Balestri, Stefano Porcelli, Daniel Souery, Siegfried Kasper, Dimitris Dikeos, Panagiotis Ferentinos, George N. Papadimitriou, Dan Rujescu, Giovanni Martinotti, Marco Di Nicola, Luigi Janiri, Elisabetta Caletti, Gian Mario Mandolini, Alessandro Pigoni, Riccardo Augusto Paoli, Matteo Lazzaretti, Paolo Brambilla, Michela Sala, Vera Abbiati, Marcella BellaniCinzia Perlini, Maria Gloria Rossetti, Sara Piccin, Carolina Bonivento, Dora Fabbro, Giuseppe Damante, Clarissa Ferrari, Roberta Rossi, Laura Pedrini, Francesco Benedetti, Stuart Montgomery, Joseph Zohar, Julien Mendlewicz, Alessandro Serretti

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)464-474
Number of pages11
JournalJournal of Affective Disorders
Publication statusPublished - Jun 1 2019


  • Bipolar disorder
  • Major depressive disorder
  • Treatment outcomes
  • Treatment resistance depression

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Temperament and character influence on depression treatment outcome'. Together they form a unique fingerprint.

Cite this