Research paperA personality-based latent class typology of outpatients with major depressive disorder: association with symptomatology, prescription pattern and social function

- Latent profile analysis was used to classify MDD patients based on personality.
- Personality was assessed by the Temperament and Character Inventory.
- Two maladaptive groups with distinct personality profiles were identified.
- These two groups demonstrated unique symptomatology and low social functioning.
- Findings shed new light on the issue of clinically meaningful subtypes of MDD.

BackgroundWhile major depressive disorder (MDD) is considered to be a heterogeneous disorder, the nature of the heterogeneity remains unclear. Studies have attempted to classify patients with MDD using latent variable techniques, yet the empirical approaches to symptom-based subtyping of MDD have not provided conclusive evidence. Here we aimed to identify homogeneous classes of MDD based on personality traits, using a latent profile analysis.MethodsWe studied 238 outpatients with DSM-IV MDD recruited from our specialized depression outpatient clinic and assessed their dimensional personality traits with the Temperament and Character Inventory. Latent profile analysis was conducted with 7 dimensions of the Temperament and Character Inventory as indicators. Relationships of the identified classes with symptomatology, prescription pattern, and social function were then examined.ResultsThe latent profile analysis indicated that a 3-class solution best fit the data. Of the sample, 46.2% was classified into a “neurotic” group characterized by high harm avoidance and low self-directedness; 30.3% into an “adaptive” group characterized by high self-directedness and cooperativeness; and 23.5% into a “socially-detached” group characterized by low reward dependence and cooperativeness and high self-transcendence. The 2 maladaptive groups, namely neurotic and socially-detached groups, demonstrated unique patterns of symptom expression, different classes of psychotropic medication use, and lower social functioning.LimitationsGeneralizability of the findings was limited since our patients were recruited from the specialized depression outpatient clinic.ConclusionsOur personality-based latent profile analysis identified clinically meaningful 3 MDD groups that were markedly different in their personality profiles associated with distinct symptomatology and functioning.