Can personality traits predict substance use remission and relapse? A Systematic Review

Abstract

Background & Aim: Personality traits can predict various health outcomes, and several studies have examined their influence on treatment responses in substance use disorders (SUD). Given SUDs' global burden and high relapse rates, identifying predictors of remission and relapse is essential. However, a comprehensive synthesis of existing studies in this area is lacking. This review aims to assess the role of personality traits in SUD remission and relapse. Methods: A systematic review was conducted following the PRISMA guidelines. Searches in the PubMed, Scopus, PsycINFO, and Web of Science databases identified studies using the NEO Personality Inventory Revised (NEO-PI-R) or equivalent instruments to assess personality traits and their associations with remission and relapse in SUD. Results: Twelve studies involving 4210 participants were included. Neuroticism was a significant risk factor for relapse in eight studies, whereas Conscientiousness was significantly associated with sustained remission in seven. Agreeableness showed a potential protective effect in five studies. Regarding Extraversion and Openness, only five and one study, respectively, showed significant associations, with contradicting results emerging for Extraversion. Conclusions: Personality traits, particularly Conscientiousness and Neuroticism, can predict SUD treatment outcomes. These findings highlight the necessity for personalized treatment incorporating personality assessments to improve remission and prevent relapse.