Exposure to stressful life events and individual differences in the personality trait neuroticism are important risk factors that interact to predict major depressive disorder (MDD). Less is known about their effect on treatment response in depression. Here, we examine whether stressful life events experienced prior to and during treatment interact with neuroticism to predict response to 16-week pharmacotherapy for MDD. Participants included 159 outpatients with MDD who were initially treated with 8 weeks of escitalopram. Those who responded to the initial treatment continued on escitalopram monotherapy, whereas non-responders received 8 weeks of adjunctive aripiprazole. Personality was assessed using the NEO-Five Factor Inventory, and stressful life events were assessed using the Life Events and Difficulties Schedule, a rigorous contextual interview that includes independent ratings of threatening life events. High baseline neuroticism was associated with a lower likelihood of response when patients experienced one or more negative life events before treatment. Secondary analyses indicated that this effect was specific to neuroticism, and not better accounted for by its self-criticism or negative affect facets. Our results suggest that assessing personality and stressful life events at baseline can help clinicians assess which patients will respond to antidepressant therapy and which may need treatment augmentation.

中文翻译：

---

神经质和压力性生活事件之间的相互作用可预测对重度抑郁症药物治疗的反应：CAN-BIND 1 报告

暴露于压力性生活事件和人格特质神经质的个体差异是预测重度抑郁症 (MDD) 相互作用的重要风险因素。关于它们对抑郁症治疗反应的影响知之甚少。在这里，我们检查了治疗前和治疗期间经历的压力性生活事件是否与神经质相互作用，以预测对 MDD 的 16 周药物治疗的反应。参与者包括 159 名 MDD 门诊患者，他们最初接受了 8 周的依他普仑治疗。对初始治疗有反应的人继续接受依他普仑单药治疗，而无反应者接受 8 周的阿立哌唑辅助治疗。人格使用NEO-五因素量表评估，压力性生活事件使用Life Events and Difficulties Schedule，一个严格的上下文访谈，包括对威胁性生活事件的独立评级。当患者在治疗前经历一个或多个负面生活事件时，高基线神经质与较低的反应可能性相关。二次分析表明，这种影响是神经质特有的，不能更好地通过其自我批评或负面影响方面来解释。我们的研究结果表明，在基线评估人格和压力性生活事件可以帮助临床医生评估哪些患者会对抗抑郁治疗产生反应，哪些患者可能需要加强治疗。