The impact of personality traits on the return of major depression: a case-control study

Nada Altaweel ^1,2,3* Rachel Upthegrove ^1,3,4 Steven Marwaha ^1,3,4,5

• ¹ University of Birmingham, Birmingham, United Kingdom
• ² Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
• ³ Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, England, United Kingdom
• ⁴ Birmingham Women's NHS Foundation Trust, Birmingham, United Kingdom
• ⁵ Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom

Background: Major depression is a common, chronic, recurrent, debilitating disorder. Despite effective treatments, remission rates remain low, and many of those who do experience remission then relapse. Some personality traits are potential risk factors for relapse, though they have, to date, received insufficient attention. There is growing attention to the role of emotional dysregulation in recurrent depression. We aimed to investigate the association between the return of major depression and emotional dysregulation, affective lability, and impulsivity personality traits. Method: A case-control design sampling adults over 18 years old with a history of depression and currently either experiencing a depressive episode (cases) or currently being free of a depressive episode (controls). Current depression was assessed using the Patient Health Questionnaire-9, and study participants were recruited online. Multistaged logistic regression modelling was used to explore the association between personality traits and the return of depression, adjusting for important confounding factors. Results: 152 respondents (76 cases and 76 controls) were recruited. Emotional dysregulation was significantly associated with the return of depression (OR=1.03, 95% CI [1.00-1.06], p= .04) even after adjustment for the confounding factors: marital status and childhood trauma. Childhood trauma (OR=1.04, 95% CI [1.00-1.08], p= .03) and being widowed, divorced, or separated (OR=13.95, 95% CI [1.16-166], p= .03) were also associated with the return of depression. Our analysis did not detect any association between affective lability and impulsivity and the return of depression. Limitations: Our study relied on self-report questionnaires, including measuring depression. We used cross-sectional data in the present study analysis. Conclusion: Our findings suggest emotional dysregulation and childhood trauma could work as risk factors and predate depression. This information can be used to develop targeted treatment plans and improve therapeutic outcomes.