Thirty-five patients with diagnosis of Axis II disorder and temperamental profile, in concurrent major depressive episode: response to short-time treatment with serotoninergic antidepressants

AIM: The aim of this study was to identify individual characteristics that might influence response to treatment in patients with a depressive episode. METHODS: Participants were interviewed using a structured clinical interview for DSM-IV Axis II (SCID-II, version 2.0) disorders, and the Italian version of Akiskal’s semi-structured clinical interview for temperamental profiles (TEMPS-I). A short-time (3 weeks) treatment with antidepressants (SSRI in therapeutic range: fluoxetine 20-80 mg/die, paroxetine 20-50 mg/die and citalopram 20-40 mg/die) is accompanied by careful monitoring of symptoms using the 21 items HAM-D scale (Hamilton Rating Scale for Depression). RESULTS: An analysis of the mean HAM-D score of our sample underlined the highest values for histrionic personality, at baseline and at all treatment intervals compared to other personality disorders, corresponding to a weaker response to treatment in terms of reduction of depressive symptoms. Moreover, the patients with an irritable temperament presented a significantly higher mean HAM-D score at baseline and at all treatment intervals respect to other temperamental traits with a lower responsiveness to SSRI. Instead there was a statistically significant effect on the mean score obtained by the HAM-D at the third week in relation to the psychopathological characteristics of the sample. This indicated a poorer improvement in depressive symptoms with decreasing age at onset of depressive symptoms, age at first psychiatric contact and age at first hospitalization. CONCLUSION: The identification of individual characteristics that might influence response to treatment in patients with a depressive episode may be extremely useful.