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Temperament and Depression After a First Acute Coronary Syndrome

Ossola, Paolo, MD*; Generali, Irene, MD*; Schito, Graziana, MD*; De Panfilis, Chiara, MD*; Tonna, Matteo, MD; Gerra, Maria Lidia, MD; Marchesi, Carlo, MD*

The Journal of Nervous and Mental Disease: April 2019 - Volume 207 - Issue 4 - p 277–283
doi: 10.1097/NMD.0000000000000964
Original Articles

Few studies assess the role of personality styles in predicting the onset of depression among cardiac patients. This study evaluates whether temperament and character can represent a risk factor for the development of incident first-ever depressive episodes in patients at their first acute coronary syndrome (ACS). Two hundred sixty-seven (72.1%) subjects (male) completed the Temperament and Character Inventory (TCI) a few days after the cardiac event. At baseline and after 1, 2, 4, 6, 9, 12, and 24 months of follow-up, the participants completed the Primary Care Evaluation of Mental Disorder (PRIME-MD) and the Hospital Anxiety and Depression Scale to establish the presence of a depressive episode and its severity. During the follow-up, 61 (22.8%) participants developed a depressive episode. Temperamental risk factors for incident depression were scored high on novelty seeking and harm avoidance at the TCI. Given the detrimental effect of depression on cardiac prognosis, clinicians should take temperament variables into account when determining the treatment plans of their patients with ACS.

*Unit of Psychiatry, Department of Medicine and Surgery, University of Parma; and

Department of Mental Health, AUSL of Parma, Parma, Italy.

Send reprint requests to Irene Generali, MD, School of Psychiatry, Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126 Parma, Italy. E-mail:

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