Neuroticism and patients' depressive symptoms: a moderated mediation model of illness perception and patient-physician trust

Patients with high neuroticism are more likely to have negative perceptions of disease and to report more depressive symptoms. The important environmental factor of patient-physician trust may buffer the negative effect of neuroticism on illness perception and thereby help to protect patients' mental health. This study examined the roles of illness perception and patient-physician trust in the relationship between neuroticism and patients' depressive symptoms. A cross-sectional survey was administered to patients of two Chinese hospitals (N = 384). The findings indicated that higher neuroticism was directly associated with depressive symptoms and indirectly associated with depressive symptoms via negative illness perception. Importantly, only the benevolence dimension of patient-physician trust was shown to moderate the indirect relationship between neuroticism and depressive symptoms: compared with patients in the low-level benevolence group, patients with high neuroticism in the high-level benevolence group reported less negative illness perceptions and, in turn, reduced depressive symptoms. The technical competence dimension of patient-physician trust showed no such moderating effect. For patients with high neuroticism, future interventions aimed at changing illness perceptions should focus not only on demonstrating technical competence and improving symptoms, but also on providing healthcare information and affectionate social support.