Abstract
The association between temperament characteristics and mood disorders has gained much attention in recent years. The Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A) is a self-rating scale measuring 5 affective temperament dimensions. In this study, we aimed to clarify whether each affective temperament of TEMPS-A is a differentiating factor between major depressive disorder (MDD), bipolar I disorder (BD-I), and bipolar II disorder (BD-II), and analyzed the utility of TEMPS-A in their differential diagnosis in a clinical setting. A total of 346 patients (MDD, n = 176; BD-II, n = 112; BD-I, n = 58) filled out TEMPS-A. To assess the patients' mood state at the time of temperament assessment, Patient Health Questionnaire-9 (PHQ-9) and Young Mania Rating Scale (YMRS) were also conducted. Multivariate logistic regression analysis demonstrated that cyclothymic and anxious temperament scores were significant factors differentiating the diagnosis of BD-I and BD-II from the diagnosis of MDD, and hyperthymic temperament score was a specific factor for the differential diagnosis of BD-I versus the diagnosis of BD-II. All of the patients included in our study received treatment in large general hospitals. Because the nature of the present study was cross-sectional, some MDD subjects in this study might have unrecognized BD-I/BD-II. Cyclothymic and anxious temperament scores assessed by TEMPS-A might enable differentiation between MDD and BD, and hyperthymic temperament score on TEMPS-A might be useful in distinguishing between BD-I and BD-II.
Highlights
Differentiating between major depressive disorder (MDD), bipolar I disorder (BD-I), and bipolar II disorder (BD-II) in the early stages of disease is clinically important [1, 2], because clinicians should take different treatment approaches for the 3 disorders and inappropriate treatment can be associated with poor prognoses
Multivariate logistic regression analysis demonstrated that cyclothymic and anxious temperament scores were significant factors differentiating the diagnosis of BD-I and BD-II from the diagnosis of MDD, and hyperthymic temperament score was a specific factor for the differential diagnosis of BD-I versus the diagnosis of BD-II
Cyclothymic and anxious temperament scores assessed by TEMPS-A might enable differentiation between MDD and BD, and hyperthymic temperament score on TEMPS-A might be useful in distinguishing between BD-I and BD-II
Summary
Differentiating between major depressive disorder (MDD), bipolar I disorder (BD-I), and bipolar II disorder (BD-II) in the early stages of disease is clinically important [1, 2], because clinicians should take different treatment approaches for the 3 disorders and inappropriate treatment can be associated with poor prognoses. Clinicians should not provide antidepressant monotherapy to patients with BD, those with BD-I, according to many treatment guidelines for mood disorders [3, 4], and inappropriate treatment of BD and an extended duration of untreated BD may increase the risk of mood instabilities and suicide attempts [1, 2]. Solmi et al [20] performed a meta-analysis and found that patients with a diagnosis of BD had significantly higher cyclothymic, hyperthymic, and irritable temperament scores compared with patients with a diagnosis of MDD To our knowledge, this is the only study to date that performed a meta-analysis to assess the association between affective temperament scores on TEMPS-A and the diagnosis of mood disorders; the subjects included were of various mental states, and the possible effects of their mental states were ignored in the meta-analysis.
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