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This study examined the association between conscientiousness and psychiatric symptomatology in a clinical sample, the stability of conscientiousness over a 6-month period, and the incremental utility of conscientiousness scores in accounting for variance in psychiatric symptomatology. Sixty-three depressed patients were assessed following inpatient discharge and at 6-month follow-up. Our sample scored 1 standard deviation below the normative mean on conscientiousness at discharge and at 6-month follow-up, with evidence of significant stability over time. However, substantial volatility in conscientiousness scores at 6-month follow-up was noted among patients with high conscientiousness scores at discharge. Conscientiousness had incremental utility in predicting depression scores at 6-month follow-up beyond the effects of social support, life stressors, and general psychiatric symptomatology. The integration of conscientiousness with current conceptualizations of depression is presented.