Personality traits in MG patients may underlie depression, anxiety
Study finds negative emotions run high, openness and confidence are lacking
Negative emotions, a personality trait known as neuroticism, are more likely in people with myasthenia gravis (MG) than those without this disease, and may explain why these patients appear to be more liable to depression and anxiety, a study suggests.
MG patients also scored lower than healthy adults for openness and social confidence or extraversion, indicating they can tend to be less engaged with the external world, the researchers noted.
“A personality profile of increased neuroticism and lower openness and extraversion in MG patients may contribute considerably to the perception of disease severity,” the researchers wrote.
“Therefore, a psychological and behavioral intervention in addition to the specific pharmacological therapy might be of particular value,” they added, building on a previous report that more than 1 in 3 MG patients experience depression and anxiety.
The study, “Personality factors in patients with myasthenia gravis: A prospective study,” was published in the journal Brain and Behavior by a team of researchers in Germany.
Depression and anxiety can trouble people with myasthenia gravis
MG is an autoimmune disease that disrupts nerve-muscle communication, resulting in disease symptoms marked by episodes of muscle weakness and fatigue. It’s also not uncommon for people with MG to note difficulties in their emotional and mental health.
“However, little is known about personality characteristics in MG patients,” the researchers, all in Germany, wrote.
In a bid to understand if and how certain personality traits may be linked to MG’s course and severity, the scientists asked 44 MG patients, with a mean age of almost 64, and 45 age- and sex-matched healthy adults to complete the 60-question NEO Five-Factor Inventory test.
This psychological test assesses five domains: openness, conscientiousness, extraversion, agreeableness, and neuroticism. For each domain, scores can range from 0 to 48 points, with higher scores indicating a stronger expression of that personality trait.
Thirteen (29.5%) patients had ocular MG and 31 (70.5%) had generalized MG, a form of the disease characterized by widespread muscle weakness and fatigue that is not confined to the ocular (eye and eyelid) muscles. Most of the patients, 31 or 70.5%, had late-onset MG, meaning their symptoms emerged after age 50.
MG patients score in high in measures of neuroticism or negative emotions
On average, MG patients scored significantly higher than healthy adults, a control group, on neuroticism (20.5 vs. 15.6 points), but significantly lower on openness (25.9 vs. 28.9 points) and extraversion (24.9 vs. 28.4 points).
MG patients with a longer disease duration also scored significantly higher for neuroticism, and significantly lower for extraversion and conscientiousness, which refers to the way in which people can control, regulate, and direct their own impulses.
Likewise, neuroticism levels also differed by MG type, being significantly higher in patients with generalized disease than in those with solely ocular symptoms.
“The present study indicates that perception and treatment of MG-related health issues should include a careful attention to personality profile, especially in higher age or even at late onset,” the researchers wrote.
MG patients also scored significantly higher than controls on the Center for Epidemiologic Studies Depression Scale, short version (11.2 vs. 5.6 points) and on the Beck Anxiety Inventory (14 vs. 4.4 points), indicating more severe symptoms of depression and anxiety.
Among patients, neuroticism correlated with both depression and anxiety scores; that is, the higher the expression of neuroticism, the more severe the symptoms of depression and anxiety.
“Findings of higher rates of neuroticism and lower extraversion and openness in MG patients, compared to controls, should raise awareness for individual personality characteristics in the long-term management of this chronic disease,” the researchers wrote.
They also noted that “knowledge on this may prompt specific questions in regard to personality characteristics already at the time of the diagnosis in order to raise additional vigilance of potential accompanying treatment factors besides neuromuscular weakness.”