Ann Arbor, MI – While personalized treatments have become commonplace in managing physical illnesses such as cancer and heart disease, mental health care has lagged behind. However, new research from the University of Michigan suggests that detailed personality assessments may offer a pathway toward individualized care for people with bipolar disorder.
The study, published in the Journal of Affective Disorders, reveals that certain combinations of personality traits—identified through comprehensive testing—can help predict the likelihood of recurring depressive episodes and difficulties in daily functioning among those living with bipolar disorder.
Researchers analyzed data from more than 2,500 individuals diagnosed with bipolar disorder, drawing from two long-term studies. Their findings indicate that personalized “personality styles,” derived from within-individual patterns rather than comparisons between people, can significantly impact mental health outcomes.
According to lead author Dr. Kelly Ryan, a neuropsychologist and professor of psychiatry at the University of Michigan, these insights could help clinicians better understand which patients may be more resilient or more vulnerable to future depressive episodes.
“These findings are really exciting because we don’t yet fully understand why some people with bipolar disorder recover quickly or have fewer depressive episodes,” Ryan said. “It appears that aspects of their personality could play a role. This opens up the possibility of using personality profiles to guide treatment planning.”
The study focused on the balance between personality styles that elevate risk and those that offer protection. Individuals with more protective traits tended to fare better in the long term. The most significant predictor of poor outcomes was a high score on the trait known as neuroticism—associated with emotional instability and negative thinking. Conversely, lower levels of neuroticism appeared to be a strong protective factor.
Importantly, traits not related to neuroticism also influenced outcomes. For instance, low scores on traits like “openness” were linked to greater risk, though these traits can potentially be modified through therapy or personal growth strategies, such as engaging in new experiences.
“Personality traits were once thought to be fixed,” Ryan noted. “But there’s growing evidence that with therapy or coaching, traits can shift over time—potentially reducing mental health risks.”
The research team utilized data from the Prechter Bipolar Research Program, which has followed hundreds of individuals for over a decade. For this study, 489 participants completed the Revised NEO Personality Inventory (NEO PI-R), a 240-item psychological assessment tool. These participants also regularly completed follow-up assessments measuring depressive symptoms and daily functioning.
Researchers categorized participants into distinct personality styles based on combinations of traits, using standard scoring practices. Some of the 30 identified styles were associated with higher depression risk and lower functioning, while others showed a protective effect.
To validate their findings, the team applied the same methodology to a larger cohort of more than 2,000 individuals from the STEP-BD study. Participants in this group completed the shorter NEO Five-Factor Inventory (NEO-FFI) and underwent regular clinical evaluations every three months.
The results were consistent: Two-thirds of the high-risk personality styles identified in the Prechter group also predicted depression in the STEP-BD group. Similarly, more than half of the protective styles from the original study were validated in the second cohort.
“This replication gives us confidence in the model,” Ryan said. “It’s not just about one trait, but the interplay between multiple personality styles that seems to matter most.”
The researchers believe that integrating personality testing into clinical care could offer new ways to tailor treatments and improve quality of life for individuals with bipolar disorder. Patients, too, may benefit from understanding their personality profiles, using the information to collaborate more effectively with their care providers.
The study was funded by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation.
Co-authors include Anastasia K. Yocum, Yuhua Zhang, Peisong Han, David F. Marshall, Paul T. Costa, Sarah H. Sperry, Takakuni Suzuki, Melvin G. McInnis, and Sebastian Zöllner. Notably, Paul T. Costa co-developed the NEO personality assessments used in the study, which are published by PAR and available to licensed professionals.
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