Temperament and character profiles of Japanese university students with depressive episodes and ideas of suicide or self-harm: A PHQ-9 screening study Nobuyuki Mitsui a, ⁎ , Satoshi Asakura a,b , Yusuke Shimizu a , Yutaka Fujii a , Yuki Kako a , Teruaki Tanaka a , Koji Oba c , Takeshi Inoue a , Ichiro Kusumi a a Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan b Health care center of Hokkaido University, Sapporo, Japan c Translation Research and Clinical Trial Center, Hokkaido University Hospital, Sapporo, Japan Abstract Objective: The aim of our study was to reveal the personality traits of individuals with major and other depressive episodes among the young adult population. Furthermore, character traits of individuals with ideas of suicide or self-harm were also investigated in this study. Methods: The subjects of this study were 1421 university students who completed the Patient Health Questionnaire (PHQ-9) and the Temperament and Character Inventory (TCI). The subjects were divided into three separate groups: the major depressive episode group (N = 41), the other depressive episode group (N = 97), and the non-depressive controls (N = 1283). This separation was achieved using the PHQ-9 algorithm diagnosis. We compared the TCI scores using an analysis of variance. Moreover, the Cochran-Armitage trend test was used to determine the diagnosis, ideas of suicide or self-harm, and analysis of character profiles. Results: The major depressive episode group had significantly higher HA (P b 0.001), lower RD (P b 0.001), lower SD (P b 0.001), and lower C (P b 0.001) scores than non-depressive controls. The other depressive episode group had significantly higher HA scores (P b 0.001) and lower SD scores (P b 0.001) than non-depressive controls. The Cochran-Armitage trend test revealed that the prevalence of depressive episodes decreased as the character profiles matured (χ 2 trend = 57.2, P b 0.0001). The same tendency was observed in individuals who had ideas of suicide or self-harm (χ 2 trend = 49.3, P b 0.0001). Conclusion: High HA and low SD scores were common personality traits among young adults with major depressive episodes. Furthermore, the immaturity of character profiles was clearly associated with depressive episodes and ideas of suicide or self-harm. © 2013 Elsevier Inc. All rights reserved. 1. Introduction Kessler et al. reported that the highest risk of initial suicide ideation, planning, and attempts took place during an individual's late teens to early 20s [1]. Accordingly, it is very important to study depression and ideas of suicide or self- harm in young adults to prevent suicide. Several studies have examined the pathogenic and predictive role of personality in depressive symptoms among the young adult population using the Temperament and Character Inventory (TCI) [2–5]. The TCI is a widely used self-rating scale for assessing personality among adult samples. The TCI consists of four dimensions of temperament [i.e., novelty seeking (NS), harm avoidance (HA), reward dependence (RD), and persistence (P)] and three dimensions of character [i.e., self-directedness (SD), cooper- ativeness (C), and self-transcendence (ST)]. Among the four temperament dimensions, high HA scores were consistently associated with depressive symp- toms in both clinical samples and general populations [6]. Recently, Kampman et al. reviewed 12 studies that focused on the relationship between TCI temperament dimensions and depressive symptoms. He concluded that high HA scores were associated with both current depressive symptoms and a depressive trait [6]. Four recent studies, comprised of young adult participants, also demonstrated the correlation Available online at www.sciencedirect.com ScienceDirect Comprehensive Psychiatry 54 (2013) 1215 – 1221 www.elsevier.com/locate/comppsych Conflicts of interest: The authors confirm that there were no conflicts of interest in writing this paper. ⁎ Corresponding author. Department of Psychiatry, Hokkaido Univer- sity Graduate School of Medicine, North 15, West 7, Kita-ku, Sapporo, 060–8638 Japan. Tel.: +81 11 716 1161; fax: +81 11 706 5081. E-mail address: nmitsui@med.hokudai.ac.jp (N. Mitsui). 0010-440X/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.comppsych.2013.05.014