Temperament and Character in Psychotic Depression Compared with Other Subcategories of Depression and Normal Controls

Background . Support has been found for high harm avoidance as general vulnerability trait for depression and decreased self-directedness (SD) as central state-related personality change. Additional personality characteristics could be present in psychotic depression (PD). Increased noradrenergic activation in PD predicts the involvement of reward dependence (RD). Methods . The data during the acute episode and after full remission from the same subjects, that we used before, were reanalyzed. The dependence of the 7 dimensions of the Temperament and Character Inventory version 9 on PD, three other subcategories of depression, and a group of normal controls was tested by MANCOVA. Results . Low RD at both time points, and low Cooperativeness during the acute episode, were found as additional characteristics of PD. Conclusion . The combination of two premorbid temperaments, high HA and low RD, and the development of a state-related reduction of two character functions, SD and CO, may be the precondition for the development of combined depressive and psychotic psychopathology.