Review ArticlePersonality Disturbances in Melancholic and Nonmelancholic Unipolar Major Depression A Systematic Review and Meta-AnalysisValerio, Marina P. MD∗,†; Blasco, Belén MD†; Tagni, Florencia MD†; Szmulewicz, Alejandro G. MD, MSc‡,§; Martino, Diego J. MD, MSc, PhD∗,∥Author Information ∗National Council of Scientific and Technical Research (CONICET) †Psychiatric Emergencies Hospital Torcuato de Alvear ‡Bipolar Disorder Program, Neurosciences Institute, Favaloro University §Pharmacology Department, University of Buenos Aires School of Medicine ∥Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Ciudad Autónoma de Buenos Aires, Argentina. Send reprint requests to Diego J. Martino, MD, MSc, PhD, Charcas 4189, 1°′′C′′ (C1425BNG), Ciudad Autónoma de Buenos Aires, Argentina. E-mail: email@example.com. The Journal of Nervous and Mental Disease: October 2020 - Volume 208 - Issue 10 - p 810-817 doi: 10.1097/NMD.0000000000001212 Buy Metrics Abstract Although melancholic depression has been associated with a more adequate premorbid personality style, the empirical evidence supporting this statement is inconclusive. We conducted a systematic review and meta-analyzed studies comparing the presence of personality disturbances in melancholic and nonmelancholic subtypes of major depressive disorder (MDD). We defined a) a continuous outcome, defining personality traits as a dimensional construct, and b) a dichotomous outcome, defined as the presence/absence of personality disorders (PD). We also evaluated the role of potential moderators. Our results showed significantly higher levels of neuroticism and interpersonal sensitivity, and a higher likelihood of presenting a PD in nonmelancholic depression. No significant differences were found for extraversion. The scarcity of studies and high heterogeneity were among our limitations. In conclusion, personality disturbances seem to be overrepresented in nonmelancholic MDD. The assessment of personality disturbances can be useful in clinical practice and in the study of MDD heterogeneity. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.