Personality traits as risk factors for relapse or recurrence in major depression: a systematic review

doi:10.3389/fpsyt.2023.1176355

. 2023 May 5:14:1176355.

doi: 10.3389/fpsyt.2023.1176355. eCollection 2023.

Personality traits as risk factors for relapse or recurrence in major depression: a systematic review

Nada Altaweel^{1

2}, Rachel Upthegrove^{1

3}, Andrew Surtees^{1

3}, Buse Durdurak¹, Steven Marwaha^{1

3

4}

Affiliations

¹ School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom.
² Department of Psychology, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
³ Birmingham Woman's and Children's NHS Foundation Trust, Birmingham, United Kingdom.
⁴ Specialist Mood Disorders Clinic, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom.

PMID: 37215669
PMCID: PMC10196019
DOI: 10.3389/fpsyt.2023.1176355

Personality traits as risk factors for relapse or recurrence in major depression: a systematic review

Nada Altaweel et al. Front Psychiatry. 2023.

. 2023 May 5:14:1176355.

doi: 10.3389/fpsyt.2023.1176355. eCollection 2023.

Authors

Nada Altaweel^{1

2}, Rachel Upthegrove^{1

3}, Andrew Surtees^{1

3}, Buse Durdurak¹, Steven Marwaha^{1

3

4}

Affiliations

¹ School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom.
² Department of Psychology, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
³ Birmingham Woman's and Children's NHS Foundation Trust, Birmingham, United Kingdom.
⁴ Specialist Mood Disorders Clinic, Birmingham and Solihull Mental Health NHS Foundation Trust, Birmingham, United Kingdom.

PMID: 37215669
PMCID: PMC10196019
DOI: 10.3389/fpsyt.2023.1176355

Abstract

Background: Major depressive disorder (MDD) is highly recurrent. Identifying risk factors for relapse in depression is essential to improve prevention plans and therapeutic outcomes. Personality traits and personality disorders are widely considered to impact outcomes in MDD. We aimed to evaluate the role of personality aspects in the risk of relapse and recurrence in MDD.

Method: A PROSPERO-registered systematic review was conducted using Medline, Embase, PsycINFO, Web of Science and CINAHL as data sources, together with hand searching of four journals over the five years till 2022. There was independent abstract selection, quality assessment and data extraction from each study.

Results: Twenty two studies me t eligibility criteria involving 12,393 participants. Neurotic personality features are significantly associated with the risk of relapse and recurrence of depression, though the data is not uniform. There is some, though limited, evidence that borderline, obsessive-compulsive and dependent personality traits or disorders increase the risk for relapse in depression.

Limitations: The small number, in addition to the methodological heterogeneity of the included studies, did not allow further analysis, such as meta-analysis.

Conclusion: People with high neuroticism and dependent personality traits, borderline personality disorder or obsessive-compulsive personality disorder, compared to those without, may be at a higher risk of experiencing relapse or recurrence of MDD. Specific and targeted interventions may potentially reduce relapse and recurrence rates in these groups and could improve outcomes.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=235919, identifier: CRD42021235919.

Keywords: depression; personality disorders; personality traits; recurrence; relapse.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**Figure 1**
Flow-diagram of the study selection process.

**Figure 2**
Personality traits that have been reported to be associated with the risk of relapse or recurrence in MDD.

See this image and copyright information in PMC

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References

1. Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res. (2020) 126:134–40. 10.1016/j.jpsychires.2019.08.002 - DOI - PubMed
1. Marwaha S, Palmer E, Suppes T, Cons E, Young AH, Upthegrove R. Novel and emerging treatments for major depression. Lancet. (2022) 25:3. 10.1016/S0140-6736(22)02080-3 - DOI - PubMed
1. Wojnarowski C, Firth N, Finegan M, Delgadillo J. Predictors of depression relapse and recurrence after cognitive behavioural therapy: a systematic review and meta-analysis. Behav Cogn Psychother. (2019) 47:514–29. 10.1017/S1352465819000080 - DOI - PubMed
1. Frank E, Prien RF, Jarrett RB, et al. . Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. (1991) 48:851–5. 10.1001/archpsyc.1991.01810330075011 - DOI - PubMed
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[1] Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res. (2020) 126:134–40. 10.1016/j.jpsychires.2019.08.002 - DOI - PubMed

[2] Liu Q, He H, Yang J, Feng X, Zhao F, Lyu J. Changes in the global burden of depression from 1990 to 2017: findings from the global burden of disease study. J Psychiatr Res. (2020) 126:134–40. 10.1016/j.jpsychires.2019.08.002 - DOI - PubMed

[3] Marwaha S, Palmer E, Suppes T, Cons E, Young AH, Upthegrove R. Novel and emerging treatments for major depression. Lancet. (2022) 25:3. 10.1016/S0140-6736(22)02080-3 - DOI - PubMed

[4] Marwaha S, Palmer E, Suppes T, Cons E, Young AH, Upthegrove R. Novel and emerging treatments for major depression. Lancet. (2022) 25:3. 10.1016/S0140-6736(22)02080-3 - DOI - PubMed

[5] Wojnarowski C, Firth N, Finegan M, Delgadillo J. Predictors of depression relapse and recurrence after cognitive behavioural therapy: a systematic review and meta-analysis. Behav Cogn Psychother. (2019) 47:514–29. 10.1017/S1352465819000080 - DOI - PubMed

[6] Wojnarowski C, Firth N, Finegan M, Delgadillo J. Predictors of depression relapse and recurrence after cognitive behavioural therapy: a systematic review and meta-analysis. Behav Cogn Psychother. (2019) 47:514–29. 10.1017/S1352465819000080 - DOI - PubMed

[7] Frank E, Prien RF, Jarrett RB, et al. . Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. (1991) 48:851–5. 10.1001/archpsyc.1991.01810330075011 - DOI - PubMed

[8] Frank E, Prien RF, Jarrett RB, et al. . Conceptualization and rationale for consensus definitions of terms in major depressive disorder: remission, recovery, relapse, and recurrence. Arch Gen Psychiatry. (1991) 48:851–5. 10.1001/archpsyc.1991.01810330075011 - DOI - PubMed

[9] Burcusa SL, Iacono WG. Risk for recurrence in depression. Clin Psychol Rev. (2007) 27:959–85. 10.1016/j.cpr.2007.02.005 - DOI - PMC - PubMed

[10] Burcusa SL, Iacono WG. Risk for recurrence in depression. Clin Psychol Rev. (2007) 27:959–85. 10.1016/j.cpr.2007.02.005 - DOI - PMC - PubMed

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Personality traits as risk factors for relapse or recurrence in major depression: a systematic review

Affiliations

Personality traits as risk factors for relapse or recurrence in major depression: a systematic review

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Affiliations

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Conflict of interest statement

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