Personality patterns and outcome in depressive and bipolar disorders

Personality traits and disorders have a strong influence on the course and outcome of depressive and bipolar disorders. Studies of the influence of personality disorders (PD) and some PD clusters on outcome of mood disorders are controversial and suggest that more specific assessment of underlying traits or dimensions is needed. Utilizing the Munich Personality test (MP-T) scales of von Zerssen, this study tries to identify specific personality traits that may influence the outcome and clinical course of unipolar endogenous depression and bipolar disorder. Six unipolar depressives and 6 bipolar patients, according tb DSM III-R and ICD 10 criteria, were assessed with the MP-T self- and family-reporting scales. Three years later, their outcome scores were correlated with the corresponding premorbid personality profile. Preliminary results show that introversion has a negative effect on outcome of unipolar melancholic depression, while extraversion, esoteric tendencies and rigidity have a positive influence. Neuroticism has a negative influence on outcome of bipolar disorder, but not on unipolar endogenous depression. Data from the literature suggest that neuroticism, hostility and social dysfunction seem to have a negative prognostic value only for nonendogenous depressives and bipolar disorder, thus supporting the notion that the diagnostic distinction between bipolar disorder, endogenous and nonendogenous depression is relevant to prognostic discussions. These observations help to understand the differences between depressive syndromes and their relationship to prognosis, but also to comprehend the role of personality in clinical and theoretical research of mood disorders.