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The Effect of Personality Dimensions on Functional Outcomes in Mood Disorders

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Abstract

Introduction

Functional impairment associated with mood disorders may be related to a characteristic “profile” of normative personality dimensions.

Methods

Individuals (age ≥ 18 years) with MDD (n = 400) or BD (n = 317), as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR), were enrolled in the IMDCP. Personality was evaluated with the Neuroticism–Extraversion–Openness Five-Factor Inventory (NEO-FFI), and functionality with the Sheehan Disability Scale and Endicott Work Productivity Scale. Path analysis using linear multiple regressions was performed to identify direct and indirect effects of personality on functional impairment.

Results

Lower conscientiousness exerted a significant direct effect on global (p = 0.017) and family life dysfunction in individuals with MDD (p = 0.002), as well as lower work productivity in both MDD (p = 0.020) and BD (p = 0.018). Lower extraversion exerted a significant direct effect on social impairment in individuals with BD (p = 0.017). Higher neuroticism and agreeableness as well as lower extraversion exerted indirect effects on global and social dysfunction in individuals with MDD via their effects on depression severity. In BD, higher neuroticism and openness indirectly affected global dysfunction. Family dysfunction was indirectly affected by higher neuroticism and openness as well as lower extraversion in MDD and BD.

Conclusion

The results suggest that discrete personality dimensions may exert direct and indirect effects on functional outcomes in individuals with mood disorders. Personalizing disease management approaches in mood disorders with emphasis on vocational rehabilitation may benefit from measurement and intervention targeting personality.

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Acknowledgments

The authors acknowledge the unrestricted grant provided by Pfizer, Canada Inc. Dr McIntyre is the guarantor for this article, and takes responsibility for the integrity of the work as a whole.

Conflict of interest

Roger McIntyre has received grants from Stanley Medical Research Institute, the National Alliance for Research on Schizophrenia and Depression (NARSAD), Eli Lilly, Janssen-Ortho, Shire, Astra-Zeneca, Pfizer and travel funds from Bristol-Myers Squibb. He has been an advisory board member for Astra Zeneca, Bristol-Myers Squibb, the France Foundation, GlaxoSmithKline, Janssen-Ortho, Solvay/Wyeth, Eli Lilly, Organon, Lundbeck, Biovail, Pfizer, Shire, Schering-Plough, and Merck. Dr McIntyre has also served on speaker bureaus for Janssen-Ortho, Astra-Zeneca, Eli Lilly, Lundbeck, Biovail, and Merck and has performed continuing CME activities for Astra-Zeneca, Bristol-Myers Squibb, the France Foundation, I3CME, Solvay/Wyeth, the Physicians’ Postgraduate Press, CME Outfitters, Optum Health, Schering-Plough, Merck and Eli Lilly. Joanna Soczynska has received travel funds from Janssen and is a recipient of the Eli Lilly Canada Fellowship Award. Mohammad Alsuwaidan has equity ownership in Sanofi-Aventis. David Muzina has received grant/research support from Repligen and has received honoraria from AstraZeneca, Pfizer, and Wyeth. Sideny Kennedy has been a consultant for St. Jude Medical, Bioavail, Eli Lilly, GlaxoSmithKline, Janssen-Ortho, Lundbeck and Merck Frost and has received honoraria from and served on speaker and advisory boards for medical education committees for Astra Zeneca, Bristol-Myers Squibb, the France Foundation, AstraZeneca, Bioavail, Eli Lilly, GlaxoSmithKline, Janssen-Ortho, Lundbeck, Servier, and Wyeth. Jessica Leen, Laura Ashley Gallaugher and Hanna Woldeyohannes declare no conflict of interest.

Compliance with ethics guidelines

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008. Informed consent was obtained from all patients for being included in the study. The IMDCP is approved by the UHN Research Ethics Board and the Institutional Review Board of the Cleveland Clinic Foundation.

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Authors and Affiliations

  1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Mohammad T. Alsuwaidan, Sidney H. Kennedy & Roger S. McIntyre

  2. Department of Pharmacology, University of Toronto, Toronto, ON, Canada

    Roger S. McIntyre

  3. Institute of Medical Science, University of Toronto, Toronto, ON, Canada

    Joanna K. Soczynska, Danielle S. Cha, Sidney H. Kennedy & Roger S. McIntyre

  4. Mood Disorders Psychopharmacology Unit, University Health Network, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada

    Jessica Leen, Joanna K. Soczynska, Laura Ashley Gallaugher, Hanna O. Woldeyohannes, Mohammad T. Alsuwaidan, Danielle S. Cha, Sidney H. Kennedy & Roger S. McIntyre

  5. Express Scripts, Cleveland, OH, USA

    David J. Muzina

  6. International Society for Affective Disorders (ISAD), London, England, UK

    Sidney H. Kennedy

  7. Cleveland Clinic, Lutheran Hospital, Cleveland, OH, USA

    Roman M. Dale

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  1. Jessica Leen
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Correspondence to Roger S. McIntyre.

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Leen, J., Soczynska, J.K., Gallaugher, L.A. et al. The Effect of Personality Dimensions on Functional Outcomes in Mood Disorders. Adv Ther 30, 671–683 (2013). https://doi.org/10.1007/s12325-013-0042-3

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