Being Artistic and Unconventional May Aid Depression Recovery

Paint those “blues” pink! Or maybe a sunburst orange.... Who would have thought that being artistic, or dreamy and imaginative, would have anything to do with depressed persons recovering their mental good health? Yet out of sundry personality traits, it is precisely these, along with being funky and adventurous, that a new study has linked with depression recovery.

The study was headed by R. Michael Bagby, Ph.D., director of clinical research at the Center for Addiction and Mental Health in Toronto. Results were published in the June Canadian Journal of Psychiatry.

Bagby and his colleagues studied 174 individuals who had been diagnosed with a major depression. Each was evaluated with the revised NEO Personality Inventory, one of the most widely used personality-evaluation yardsticks and one that is applicable across languages, cultures, and countries. The five major personality traits captured by the inventory are neuroticism, extraversion, openness, agreeableness, and conscientiousness; these five traits in turn encompass 30 personality facets.

The subjects were then randomized to receive either an antidepressant or cognitive-behavioral therapy (CBT) treatment for a 16- or 20-week period.

Both groups experienced, on average, significant reductions in depression. However, individuals within each group varied in their treatment response, so the researchers assessed whether their personalities had anything to do with this variation and discovered that this was in fact the case.

Out of the five personality traits, only one—openness—was significantly linked with treatment outcome. Specifically, higher scores on openness at pretreatment were significantly linked with less depression at treatment completion than were lower scores on this trait. Moreover, higher scores on four particular facets of openness—being artistic, dreamy and imaginative, adventurous, and unconventional—were also significantly linked with less depression at treatment completion.

And when the researchers assessed whether there were any significant personality-trait–treatment-response interactions, they found one—for neuroticism. Specifically, subjects who had scored higher on neuroticism at pretreatment and who then received an antidepressant experienced significantly less depression at treatment completion than did those subjects who had scored higher on neuroticism at pretreatment and who then received CBT.

And when the researchers looked to see whether there were significant personality-facet-treatment-response interactions, they found three. They concerned the facets of trust, straightforwardness, and tender-mindedness, all of which come under the agreeableness trait. More specifically, those subjects who scored higher on tender-mindedness, or lower on trust or straightforwardness, and who then received an antidepressant experienced significantly less depression at treatment completion than did those subjects who had scored comparably on these three facets at pretreatment and who then received CBT.

Some of these results did not surprise Bagby and his group, they said in their study report. For instance, the reason why neurotic depressed subjects who got an antidepressant tended to be less depressed after treatment than neurotic depressed subjects who got CBT could well be due to antidepressants stabilizing turbulent negative emotions better than CBT does.

But other results did come as a surprise, they acknowledged. For example, they had no explanation for why tender-minded subjects, that is, those who were sympathetic and soft-hearted, and who received an antidepressant had less depression at the end of treatment than did tender-minded subjects who received CBT.

In any event, Bagby and his team believe that depressed patients' treatment responses might be optimized if their personalities are taken into consideration. For instance, they suggested, it might be wise to first give neurotic depressed patients an antidepressant in order to stabilize their negative emotions and then to follow-up with some CBT sessions when they are calmer and more capable of deploying CBT strategies. Also, “as CBT has been demonstrated to confer a slight advantage over antidepressant medication in the prevention of depression recurrence,” the researchers noted,“ this sequencing strategy maximizes the benefits of the superior effects of SSRIs in the treatment of the acute episode and the protective effects of CBT for recurrence.”

The study was funded by the Ontario Mental Health Foundation, Canadian Institute of Health Research, and U.S. National Institute on Aging.

“Personality and Differential Treatment Response in Major Depression: A Randomized Controlled Trial Comparing Cognitive-Behavioral Therapy and Pharmacotherapy” is posted at<www.cpa-apc.org> under the June issue. ▪