Affective Temperaments and Clinical Course of Bipolar Disorder: An Exploratory Study of Differences among Patients with and without a History of Violent Suicide Attempts.

Giovanna Fico,Vito Caivano,Andrea Fiorillo,Mario Luciano,Marco Carfagno,Luca Steardo,Francesca Zinno,Gaia Sampogna

doi:10.3390/medicina55070390

Abstract

Background and Objectives: Suicide is the leading cause of death in patients with Bipolar Disorder (BD). In particular, the high mortality rate is due to violent suicide attempts. Several risk factors associated with suicide attempts in patients with BD have been identified. Affective temperaments are associated with suicidal risk, but their predictive role is still understudied. The aim of this study is to assess the relationship between affective temperaments and personal history of violent suicide attempts. Materials and Methods: 74 patients with Bipolar Disorder type I (BD-I) or II (BD-II) were included. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (short TEMPS-M) and the Temperament and Character Inventory, revised version (TCI-R). The sample was divided into two groups on the basis of a positive history for suicidal attempts and the suicidal group was further divided into two subgroups according to violent suicide attempts. Results: Violent suicide attempts were positively associated with the cyclothymic temperament and inversely to the hyperthymic one. BD-I patients and patients with a clinical history of rapid cycling were significantly more represented in the group of patients with a history of violent suicide attempts. Conclusions: Our study highlights that several clinical and temperamental characteristics are associated with violent suicide attempts, suggesting the importance of affective temperaments in the clinical management of patients with BPI.

Highlights

According to the World Health Organization (WHO), suicide is one of the leading causes of death worldwide accounting for nearly 800,000 deaths every year [1]
All patients filled in the short version of the Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego [32,33], a 35 items questionnaire used to assess affective temperaments described by Akiskal using a dimensional approach with a five-point Likert type scale ranging from 1 to 5 (1 = “not at all”; 2 = “a little”; 3 = “moderately”; 4 = “much”; 5 “very much”) [34] and the Temperament and Character Inventory, revised version (TCI-R) [35]
Psychotic symptoms are more frequent in patients with a history of suicide attempts compared to patients without a history of suicide attempts (p < 0.019), and during mixed episodes (p < 0.008)

Summary

Introduction

According to the World Health Organization (WHO), suicide is one of the leading causes of death worldwide accounting for nearly 800,000 deaths every year [1]. Psychiatric disorders are an important contributing factor to suicide attempts [2] and bipolar disorders (BDs) are associated with the highest suicide risk [3], which is 15–30 times higher than the general population. Up to one-half of patients with BDs attempt suicide in their lifetime [4]. Suicide is the leading cause of death in patients with Bipolar. Several risk factors associated with suicide attempts in patients with BD have been identified. Affective temperaments are associated with suicidal risk, but their predictive role is still understudied. The aim of this study is to assess the relationship between affective temperaments and personal history of violent suicide attempts. Materials and Methods: 74 patients with Bipolar Disorder type I (BD-I) or II (BD-II) were included. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (short TEMPS-M) and the Temperament and Character

Objectives

Methods

Results

Discussion

Conclusion