Abstract
Background: Affective temperament may strongly influence psychopathological characteristics in mood disorders such as clinical course of major or minor affective episodes, predominant polarity, clinical symptoms, long term clinical course, suicidality, and response/adherence to medication.Objective: The objective of this work is evaluate the association between affective temperament and clinical characteristics in bipolar disorder (BD) patients.Method: 88 euthymic bipolar patients were evaluated through Hamilton Depression Scale (HAM-D), Young Mania Rating Scale (YMRS), Clinical Global Impressions Scale for use in bipolar illness (CGI-BP), and TEMPS-Rio de Janeiro. Identification, sociodemographic data, and clinical information as age on disease onset, number of manic episodes, number of depressive episodes, polarity of first affective episode, and history of suicidal attempts, if any, from each patient were collected.Results: Our results founded that high scores in cyclothymic, irritable, depressive and anxious temperaments were associated with at least one suicide attempt. Higher scores of anxious temperament were associated with depressive polarity in the first episode of the disease as well as higher amount of manic episodes. Higher scores of hyperthymic temperament were associated with manic polarity in the first episode of the disease. Higher scores of depressive temperament were associated with higher scores in total HAM-D and specifically with higher scores in items 1 and 2 of HAM-D, i.e., depressive mood and guilt. No correlation was found between temperament and intensity of subsyndromal manic symptoms.Conclusion: We concluded that affective temperaments in BD are associated with history of suicide attempts, seem to influence polarity of first episode and that depressive temperament seems to relate to more intense subsyndromal depressive symptoms, especially depressive mood and guilt.
Highlights
Temperament may be defined as the fundamental affective attitude, the emotional soundtrack that precedes experience and leads to it 1
Higher scores of depressive temperament were associated with higher scores in total Hamilton Depression Scale (HAM-D) and with higher scores in items 1 and 2 of HAM-D, i.e., depressive mood and guilt
We concluded that affective temperaments in bipolar disorder (BD) are associated with history of suicide attempts, seem to influence polarity of first episode and that depressive temperament seems to relate to more intense subsyndromal depressive symptoms, especially depressive mood and guilt
Summary
Temperament may be defined as the fundamental affective attitude, the emotional soundtrack that precedes experience and leads to it 1. Hippocrates’s humoral theory, further developed by Galen, related the four humors to four types of temperament: sanguine (blood), choleric (yellow bile), melancholic (black bile) and phlegmatic (phlegm). Based on those concepts Emil Kraepelin described four basic affective dispositions – depressive, manic, cyclothymic and irritable – and proposed that imbalance among those was the fundamental cause of the several mental disorders. For Kraepelin, the four basic affective temperaments were subclinical variations of the manicdepressive insanity, partially equivalent to the current mood disorders – bipolar disorder (BD) and major depressive disorder Such basic temperaments were characteristics of patients suffering from manicdepressive insanity, but were present in their blood relatives 1. Affective temperament may strongly influence psychopathological characteristics in mood disorders such as clinical course of major or minor affective episodes, predominant polarity, clinical symptoms, long term clinical course, suicidality, and response/adherence to medication
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