Temperament and character inventory dimensions as a predictor of response to antidepressant treatment in major depression

Abstract Background: Cloninger’s theory of personality, including 4 temperament dimensions and 3 character dimensions, is one of the most noteworthy theories in recent years. Several studies have explored temperament dimensions as a predictor of response to antidepressant treatments in major depression, but these have provided inconsistent results. The present study explored temperament as well as character dimensions, as measured by the Temperament and Character Inventory (TCI), as possible predictors of response to maprotiline, the most-widely prescribed antidepressant in Japan. Methods: 86 consecutive patients with major depression underwent a 16-week open trial of maprotiline. They filled out the TCI at baseline, and were followed up at weeks 8 and 16 by using the Hamilton Rating Scale for Depression. Results: Hierarchial logistic regression analyses demonstrated that response to maprotiline was significantly predicted by the cooperativeness score at the 8-week outcome assessment, and by the self-directedness score at the 16-week outcome assessment, after controlling the possible effects of clinical variables on the response. There was no evidence that either temperament dimensions or their 2-way interactions significantly predicted the response. Limitations: Large replication studies with other antidepressants are needed for generalizing the results in this study. Conclusions: The results in this study regarding temperament dimensions seem consistent with findings in previous studies, which are, as a whole, inconsistent with each other. It is suggested that character dimensions (particularly cooperativeness and self-directedness), rather than temperament dimensions, may be important predictors of response to antidepressants. Antidepressants may differ in the personality configurations that predict optimal responses.