Clinical outcomes of older depressed patients with and without comorbid neuroticism
Open accessAbstract
BACKGROUND: Neuroticism is a psychological construct that includes tendency to exhibit negative affect (NA), having poor stress tolerance and being at risk for depression and anxiety disorders. The consequences of neuroticism in the elderly adults are understudied. We hypothesized that older depressed patients with comorbid neuroticism at baseline would have worse mood and cognitive outcomes compared with older depressed patients without neuroticism. METHODS: One hundred and ten older depressed adults completed baseline self-reports of depression and the NEO-Personality Inventory as a measure of neuroticism, were administered a battery of cognitive tests annually and were seen by a study psychiatrist who assessed patients using the Montgomery Åsberg Depression Rating Scale (MADRS) and treated patients with antidepressants using an established treatment guideline. Patients were followed as clinically indicated for up to three years. We measured remission (defined as MADRS score ≤ 6) rates at one year as a categorical outcome. In addition, we used Cox proportional hazard models to examine the relationship between neuroticism and change in MADRS and cognitive score over time. RESULTS: Non-remitters (30%) at one year had higher scores in total neuroticism (TN), vulnerability to stress (VS), and NA. Over three years, time to achieve remission was associated with higher TN, higher VS, and greater NA. In analyses controlling for baseline cognitive score, age, sex, and education, VS was associated with baseline to two-year change in cognition. CONCLUSIONS: Presence of neuroticism in older depressed patients treated with medication is associated with poor mood outcomes and may indicate increased risk of cognitive decline.
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In older adults, neuroticism helps maintain major depression and harms cognitive function.
“The presence of neuroticism also perpetuates major depression in older adults and is detrimental to the cognitive functioning of this cohort34.”
From State of the Science of Neural Systems in Late‐Life Depression: Impact on Clinical Presentation and Treatment Outcome (2018) · cites this paper as [34]
The present findings replicate and extend existing evidence that neuroticism, and vulnerability to stress specifically, affects both treatment response and cognitive decline in late-life major depression.
“The present findings replicate and extend existing evidence for the impact of neuroticism, and VS specifically, on both treatment response and cognitive decline in LLD (18, 19).”
From Neuroticism Traits Selectively Impact Long Term Illness Course and Cognitive Decline in Late-Life Depression (2017) · cites this paper as [18]
Preliminary evidence indicated that high total neuroticism and the vulnerability to stress trait were the only neuroticism scores associated with worse one-year antidepressant treatment response and two-year decline in global cognitive functioning in late-life major depression.
“Our preliminary evidence indicated high total neuroticism and the VS trait were the only neuroticism scores associated with both a worse one-year antidepressant treatment response and a two-year decline in global cognitive functioning in LLD (18, 19).”
From Neuroticism Traits Selectively Impact Long Term Illness Course and Cognitive Decline in Late-Life Depression (2017) · cites this paper as [18]
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Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
A new depression scale designed to be sensitive to change
Montgomery, S. A., & Åsberg, M. (1979) · British Journal of Psychiatry · doi:10.1192/bjp.134.4.382 · Cited by 13,962 · see citing works
Moms, J. C., Heyman, A., Mohs, R. C., Hughes, J. P., van Belle, G., Fillenbaum, G., Mellits, E. D., & Clark, C. (1989) · Neurology · doi:10.1212/wnl.39.9.1159 · Cited by 4,130 · see citing works
Public health significance of neuroticism
Lahey, B. B. (2009) · American Psychologist · doi:10.1037/a0015309 · Cited by 1,901 · cited 1× · see citing works
“Although neuroticism has been shown to decrease with aging (Costa and McCrae, 2006), it clearly has public health importance, as it limits quality of life and longevity (Lahey, 2009).”
BackgroundWelsh, K. A., Butters, N., Mohs, R. C., Beekly, D., Edland, S., Fillenbaum, G., & Heyman, A. (1994) · Neurology · doi:10.1212/wnl.44.4.609 · Cited by 951 · see citing works
Personality and Major Depression: A Swedish Longitudinal, Population-Based Twin Study
Kendler, K. S., Gatz, M., Gardner, C. O., & Pedersen, N. L. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.10.1113 · Cited by 663 · see citing works
Clinically defined vascular depression
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.4.562 · Cited by 557 · see citing works
A total score for the CERAD neuropsychological battery
Chandler, M. J., Lacritz, L. H., Hynan, L. S., Barnard, H. D., Allen, G., Deschner, M., Weiner, M. F., & Cullum, C. M. (2005) · Neurology · doi:10.1212/01.wnl.0000167607.63000.38 · Cited by 387 · see citing works
Ormel, J., Oldehinkel, A. J., & Brilman, E. I. (2001) · American Journal of Psychiatry · doi:10.1176/appi.ajp.158.6.885 · Cited by 330 · see citing works
Prevalence of depression among older Americans: the Aging, Demographics and Memory Study
Steffens, D. C., Fisher, G. G., Langa, K. M., Potter, G. G., & Plassman, B. L. (2009) · International Psychogeriatrics · doi:10.1017/s1041610209990044 · Cited by 273 · see citing works
Self-citationChronic distress and incidence of mild cognitive impairment
Wilson, R. S., Schneider, J. A., Boyle, P. A., Arnold, S. E., Tang, Y., & Bennett, D. A. (2007) · Neurology · doi:10.1212/01.wnl.0000264930.97061.82 · Cited by 267 · see citing works
Chronic Psychological Distress and Risk of Alzheimer’s Disease in Old Age
Wilson, R. S., Arnold, S. E., Schneider, J. A., Kelly, J. F., Tang, Y., & Bennett, D. A. (2006) · Neuroepidemiology · doi:10.1159/000095761 · Cited by 266 · see citing works
Age changes in personality and their origins: Comment on Roberts, Walton, and Viechtbauer (2006).
Costa, P. T., & McCrae, R. R. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.1.26 · Cited by 265 · see citing works
Anxiety, Cognitive Performance, and Cognitive Decline in Normal Aging
Wetherell, J. L., Reynolds, C. A., Gatz, M., & Pedersen, N. L. (2002) · The Journals of Gerontology Series B · doi:10.1093/geronb/57.3.p246 · Cited by 200 · see citing works
Stress-Related Negative Affectivity and Genetically Altered Serotonin Transporter Function
Jacobs, N., Kenis, G., Peeters, F. P. M. L., Derom, C. A., VLIETINCK, R. F., & van Os, J. (2006) · Archives of General Psychiatry · doi:10.1001/archpsyc.63.9.989 · Cited by 190 · see citing works
Dimensional personality traits and treatment outcome in patients with major depressive disorder
Quilty, L. C., Fruyt, F. D., Rolland, J., Kennedy, S. H., Rouillon, P. F., & Bagby, R. M. (2007) · Journal of Affective Disorders · doi:10.1016/j.jad.2007.10.022 · Cited by 174 · see citing works
Amygdala Reactivity and Mood-Congruent Memory in Individuals at Risk for Depressive Relapse
Ramel, W., Goldin, P. R., Eyler, L. T., Brown, G. G., Gotlib, I. H., & McQuaid, J. R. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2006.05.004 · Cited by 140 · see citing works
Distress proneness and cognitive decline in a population of older persons
Wilson, R. S., Bennett, D. A., de Leon, C. F. M., Bienias, J. L., Morris, M. C., & Evans, D. A. (2004) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2004.04.005 · Cited by 129 · see citing works
Does Personality Affect Risk for Dementia? A Systematic Review and Meta-Analysis
Low, L., Harrison, F., & Lackersteen, S. M. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2012.08.004 · Cited by 125 · see citing works
Hayward, R. D., Taylor, W. D., Smoski, M. J., Steffens, D. C., & Payne, M. E. (2013) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2012.11.012 · Cited by 119 · see citing works
Self-citationde Beurs, E., Beekman, A. T. F., Geerlings, S. W., Deeg, D. J. H., van Dyck, R., & van Tilburg, W. (2001) · The British Journal of Psychiatry · doi:10.1192/bjp.179.5.426 · Cited by 118 · see citing works
Risk for depression and neural responses to fearful facial expressions of emotion
Chan, S. W. Y., Norbury, R., Goodwin, G. M., & Harmer, C. J. (2009) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.047993 · Cited by 117 · see citing works
Jang, Y., Clay, O. J., Roth, D. L., Haley, W. E., & Mittelman, M. S. (2004) · The Gerontologist · doi:10.1093/geront/44.3.311 · Cited by 68 · see citing works
Neuroticism Does Not Affect Cognitive Functioning in Later Life
Jelicic, M., Bosma, H., Ponds, R. W. H. M., Van Boxtel, M. P. J., Houx, P. J., & Jolles, J. (2003) · Experimental Aging Research · doi:10.1080/03610730303704 · Cited by 55 · cited 2× · see citing works
“, 2005; 2006; 2007), though not in others (Wetherell et al., 2002; Jelicic et al., 2003).”
BackgroundPsychometric properties of the German version of the NEO-FFI in psychosomatic outpatients
Schmitz, N., Hartkamp, N., Baldini, C., Rollnik, J. D., & Tress, W. (2001) · Personality and Individual Differences · doi:10.1016/s0191-8869(00)00173-2 · Cited by 52 · see citing works
Mastery and Neuroticism Predict Recovery of Depression in Later Life
Steunenberg, B., Beekman, A. T. F., Deeg, D. J. H., Bremmer, M. A., & Kerkhof, A. J. F. M. (2007) · American Journal of Geriatric Psychiatry · doi:10.1097/01.jgp.0000236595.98623.62 · Cited by 52 · see citing works
Enns, M. W., & Cox, B. J. (2005) · The Canadian Journal of Psychiatry · doi:10.1177/070674370505001206 · Cited by 48 · see citing works
NEO-FFI factor scores as predictors of clinical response to fluoxetine in depressed outpatients
Petersen, T., Papakostas, G. I., Bottonari, K. A., Iacoviello, B. M., Alpert, J. E., D, M. F. M., & Nierenberg, A. A. (2002) · Psychiatry Research · doi:10.1016/s0165-1781(01)00359-6 · Cited by 36 · see citing works
Karp, J. F., Frank, E., Anderson, B., George, C. J., Reynolds, C. F., Mazumdar, S., & Kupfer, D. J. (1993) · Depression · doi:10.1002/depr.3050010503 · Cited by 33 · see citing works
Personality Traits Influence Clinical Outcome in Day Hospital-Treated Elderly Depressed Patients
Canuto, A., Giannakopoulos, P., Meiler‐Mititelu, C., Delaloye, C., Herrmann, F. R., & Weber, K. (2009) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181987536 · Cited by 26 · see citing works
Flagged first, then by citations
2 of the 32 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Szymkowicz, S. M., Gerlach, A., Homiack, D., & Taylor, W. D. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02464-9 · Cited by 212 · see citing works
Ward, J., Graham, N., Strawbridge, R. J., Ferguson, A., Jenkins, G. D., Chen, W., Hodgson, K., Frye, M. A., Weinshilboum, R. M., Uher, R., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0203896 · Cited by 63 · see citing works
Impact of Personality on Cognitive Aging: A Prospective Cohort Study
Caselli, R. J., Dueck, A. C., Locke, D. E. C., Henslin, B. R., Johnson, T. A., Woodruff, B. K., Hoffman‐Snyder, C., & Geda, Y. E. (2016) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617716000527 · Cited by 57 · see citing works
Manning, K. J., Chan, G., & Steffens, D. C. (2017) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2016.10.006 · Cited by 41 · see citing works
Self-citationSteffens, D. C., Wang, L., Manning, K. J., & Pearlson, G. D. (2017) · The American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2017.03.017 · Cited by 40 · see citing works
Self-citationSadeq, N. A., & Molinari, V. (2017) · Clinical Gerontologist · doi:10.1080/07317115.2017.1407981 · Cited by 35 · see citing works
Manning, K. J., & Steffens, D. C. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15353 · Cited by 33 · see citing works
Self-citationJardim, G. B. G., von Gunten, A., Filho, I. G. D. S., Ziegelmann, P. K., Bumaguin, D. B., Nogueira, E. L., Engroff, P., & Neto, A. C. (2019) · International Psychogeriatrics · doi:10.1017/s1041610219000073 · Cited by 32 · see citing works
Methodology and preliminary results from the neurobiology of late-life depression study
Steffens, D. C., Manning, K. J., Wu, R., Grady, J. J., Fortinsky, R. H., & Tennen, H. A. (2015) · International Psychogeriatrics · doi:10.1017/s1041610215001386 · Cited by 22 · see citing works
Self-citationSteffens, D. C., Wu, R., Grady, J. J., & Manning, K. J. (2017) · International Psychogeriatrics · doi:10.1017/s1041610217002551 · Cited by 21 · see citing works
Self-citationEffects of stressful life events on cerebral white matter hyperintensity progression
Johnson, A. D., McQuoid, D. R., Steffens, D. C., Payne, M. E., Beyer, J. L., & Taylor, W. D. (2016) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4644 · Cited by 21 · see citing works
Self-citationRole of perceived stress in postoperative delirium: an investigation among elderly patients
Banjongrewadee, M., Wongpakaran, N., Wongpakaran, T., Pipanmekaporn, T., Punjasawadwong, Y., & Mueankwan, S. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1523881 · Cited by 17 · see citing works
Miyatsu, T., Smith, B. M., Koutnik, A. P., Pirolli, P. L. T., & Broderick, T. J. (2023) · Frontiers in Physiology · doi:10.3389/fphys.2022.1070285 · Cited by 16 · see citing works
Kudo, Y., Nakagawa, A., Wake, T., Ishikawa, N., Kurata, C., Nakahara, M., Nojima, T., & Mimura, M. (2016) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s123788 · Cited by 13 · see citing works
Nogami, W., Nakagawa, A., Katayama, N., Kudo, Y., Amano, M., Ihara, S., Kurata, C., Kobayashi, Y., Sasaki, Y., Ishikawa, N., et al. (2022) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s384705 · Cited by 7 · see citing works
Jardim, G. B. G., Gomes, I., Gholam‐Rezaee, M., Ranjbar, S., Engroff, P., Santos, M. A., Neto, A. C., & von Gunten, A. (2022) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/08919887221119979 · Cited by 5 · see citing works
Personality Disorders in Later Life
Lederer, G., Freedman, D. C., Zamora, A., & Zweig, R. A. (2020) · Comprehensive Clinical Psychology · doi:10.1016/b978-0-12-818697-8.00022-4 · Cited by 2 · see citing works
Moderators of treatment response in late-life depression
Steffens, D. C., Diniz, B. S., Jain, N., Kluewer-DAmico, J., Manning, K. J., & Wang, L. (2026) · Neuropsychopharmacology · doi:10.1038/s41386-026-02337-x · Cited by 1 · see citing works
Self-citationFive Personality Traits in Late-onset Depression in Hong Kong
Chik, J. D.-W., Poon, T. K., & Ng, R. M.-K. (2019) · East Asian Archives of Psychiatry · doi:10.12809/eaap1761 · Cited by 1 · see citing works
Borza, T. (2017) · NORA - Norwegian Open Research Archives
Nürnberger, J. I. (2019) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.734054356.793563008
Chapter 9. Depressive Disorders
Andrews, P., & Taylor, W. D. (2022) · American Psychiatric Association Publishing eBooks · doi:10.1176/appi.books.9781615375196.ds09
Mulalint, 1. T., Seeherunwong, 2. A., Tongsai, 3. S., & Wanitkun, 4. N. (2024) · Research Square · doi:10.21203/rs.3.rs-4108211/v1
Steffens, D. C. (2025) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2025.07.004
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- Authors
- Steffens, D. C., McQuoid, D. R., Smoski, M. J., & Potter, G. G.
- Affiliations
- UConn Health (US)
- Duke Medical Center (US)
- Corresponding author
- Steffens, David C.
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2013-12
- Volume
- 25
- Issue
- 12
- Pages
- 1985-1990
- ISSN
- 1041-6102 (ISSN-L)
- PMC
- PMC3830609
- OpenAlex
- W1976767647
- Cited by
- 24
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 1
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (K24MH070027, R01MH054846, R01MH096725, K23MH087741)
- NIH Clinical Center
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- neuroticism, geriatric depression, comorbidities, depression remission, cognitive decline, negative affect, vulnerability to stress, personality traits, antidepressant treatment
- MeSH terms
- Neuroticism, Aged, Antidepressive Agents, Anxiety Disorders, Depression, Female, Humans, Male, Neuropsychological Tests, Personality Inventory, Psychiatric Status Rating Scales, Remission Induction, Risk Factors, Treatment Outcome, Cognitive Dysfunction
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