Cyclothymic Affective Temperament Research Articles

Cyclothymic affective temperament and low positive attitude coping strategies as predictors of comorbid depressive symptomatology in adult ADHD patients

IntroductionAttention deficit hyperactivity disorder (ADHD) in adults could be frequently underdiagnosed due to concomitant psychiatric disorders, including depressive symptomatology, which could determine inappropriate treatments. Our study aims at clinically characterizing adult ADHD with or without depressive symptomatology in order to identify the relationship with specific affective temperamental profiles and coping strategies. MethodsA total of 225 outpatients consecutively afferent to our outpatient adult ADHD service since September 2019 were retrospectively screened for eligibility and administered Beck Depression Inventory-II (BDI-II), Coping Orientation to Problems Experienced Inventory (COPE-NV) and Temperament Evaluation of the Memphis, Pisa, Paris and San Diego (TEMPS-M). Results64.7 % of patients displayed a significant comorbid depressive symptomatology. According to the multivariate linear regression model, depressive levels were positively predicted by TEMPS-M cyclothymic subscale (B = 0.567, p = 0.004) and negatively predicted by COPE-NVI “positive attitude” subscale (B = −0.438, p = 0.024) (R = 0.496, R2 = 0.246, F(2,66) = 10.747, p < 0.001). LimitationWhile considering the results, it should be taken in consideration that: the assessment was carried out only at baseline, our sample is constituted only by adult ADHD patients and mostly without a previous ADHD diagnosis, the presence of a discrepancy between the rates of ADHD subtypes, the absence of a healthy control group and emotional dysregulation was not directly assessed. ConclusionAffective temperamental profiles and coping strategies could help in clinically characterizing and personalizing treatment in adult comorbid ADHD-depressive symptomatology patients. Further research is warranted to explore the efficacy of targeted psychotherapeutic and pharmacological interventions within this ADHD sub-sample.

Adherence to dietary recommendations mediates the effect of affective temperaments on infertility treatment outcomes

Affective temperaments have been shown to robustly affect infertility treatment success. However, identification of possible mediating factors through which they exert their influence is still lacking. A growing number of results suggest that adherence to recommended treatments may be such a mediator, on the one hand, because affective temperaments are known to influence adherence and, on the other hand, because non-adherence negatively influences the treatment outcome. Recommended treatment of infertility involves, beyond medications, dietary and lifestyle changes. The aim of this retrospective cohort study was to evaluate whether adherence to physician-prescribed diet and physical activity recommendations mediates the effect of affective temperaments on infertility treatment outcomes. Among 308 women who underwent infertility treatment in an Assisted Reproduction Center, affective temperaments, adherence to diet, adherence to physical exercise, and infertility treatment success (clinical pregnancy) were assessed besides detailed medical history and demographic parameters. Associations between affective temperaments, adherence to diet and recommended physical activity, and assisted reproduction outcomes were analyzed using generalized linear models and causal mediation analysis. Adherence to physical activity didn’t have an effect, but diet adherence increased the odds of infertility treatment success by 130% suggesting its role as a potential mediator. Based on causal mediation analysis, higher depressive and anxious temperament scores were directly associated with 63% and 45% lower odds of achieving clinical pregnancy, respectively, with effects not mediated by diet adherence. Higher irritable temperament scores indirectly decreased the odds of achieving clinical pregnancy by 14%, mediated by diet adherence; while higher cyclothymic temperament scores decreased the odds of achieving clinical pregnancy both directly by 51% and indirectly, mediated by diet adherence by 11%. Our results suggest that diet adherence mediates the mechanism by which irritable and cyclothymic affective temperaments influence IVF treatment success. Since adherence is a modifiable risk factor of infertility treatment success, screening for affective temperaments may help to identify potentially high-risk non-adherent patient groups and offer patient-tailored treatment, which may help increase the chances of a successful pregnancy and live birth in women undergoing IVF treatment.

Dominant depressive, anxious and cyclothymic affective temperaments lower the chance of infertility treatment success

IntroductionAffective temperaments can play a significant role in the development, progression and outcome of various somatic diseases, as well as in the effectiveness of their treatment. Although infertility is influenced by both physical and psychological factors, the relationship between affective temperaments and infertility treatment success remains unexplored.ObjectivesThe aim of this retrospective cohort study was to assess how dominant affective temperaments influence the outcome of infertility treatments.MethodsData was collected from a cohort of infertile women who underwent infertility treatment at an Assisted Reproduction Center in Budapest, Hungary. The study recorded treatment success defined as clinical pregnancy, detailed medical history, demographic parameters, and administered the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). TEMPS-A scores then were classified into nondominant and dominant temperaments for each scale, based on their score being above or below the mean+2 standard deviation for the given temperament. The predictive value of dominant temperaments on assisted reproduction outcomes were analyzed by multivariate logistic regression models, using age, BMI and previous miscarriage as covariates.ResultsIn the cohort of 578 women who underwent infertility treatment, besides age, BMI, and previous miscarriage, dominant depressive, anxious and cyclothymic temperament decreased the odds of achieving clinical pregnancy by 85% (p=0.01), 64% (p=0.03), and 60% (p=0.050), respectively).ConclusionsThe findings of this study suggest that dominant affective temperaments have a significant impact on the outcomes of infertility treatments. As a clinical consequence, creening for affective temperaments, Identifying dominant affective temperaments, stratifying high-risk patient groups, and offering personalized treatment options may enhance the likelihood of successful pregnancy and live birth for women undergoing in vitro fertilization treatment.Disclosure of InterestNone Declared

Association between affective temperaments and psychosomatic symptoms in women with Hashimoto's thyroiditis.

Hashimoto's thyroiditis (HT) is a prevalent autoimmune disease of thyroid gland with a shared immunological mechanism with mood disorders. Affective temperament (AT) is a biologically determined personality trait that has been linked to mood disorders. The aim of this study was to examine the association between dominant AT and levels of psychosomatic symptoms in women newly diagnosed with HT in comparison to clinically healthy subjects. The observational cross-sectional study with nested case control study was involving 146 consecutive participants, who were divided into three groups. The two study groups consisted of women with HT (73), including 49 with hypothyroid HT and 24 with euthyroid HT, and the third group was a control group of healthy participants (73). The Serbian version of the TEMPS-A was utilized to assess AT, while the 4DSQ was used to measure psychosomatic symptoms. The results showed that hyperthymic AT was dominant in all examined groups. The groups with HT differed from the control group in terms of depressive and cyclothymic AT. Furthermore, the study found higher levels of psychosomatic symptoms in the group with HT compared to the control group, with significant differences in distress (p = 0.005) and somatization (p = 0.023) levels. All AT was associated with levels of psychosomatic symptoms in subjects with hypothyroid HT. In contrast, in subjects with euthyroid HT, the association was only found between depressive and cyclothymic AT with distress and depression levels, as well as between somatization and cyclothymic AT. No association was found between AT and anxiety levels in subjects with euthyroid HT. The research found differences between study groups in the association between AT and levels of psychosomatic symptoms. Further research with a larger sample size is necessary to more clearly define the associations between affective temperaments and psychosomatic symptoms in women with euthyroid and hypothyroid HT.

Cyclothymic affective temperament is independently associated with left ventricular hypertrophy in chronic hypertensive patients

ObjectiveAffective temperaments (depressive, anxious, irritable, hyperthymic, and cyclothymic) are regarded as the stable core of personality and when present in their dominant form, are considered subclinical manifestations and high-risk states for various affective disorders. Furthermore, cumulating evidence supports their relationship with cardiovascular diseases. Our aim was to assess the association between affective temperaments and left ventricular hypertrophy (LVH) in chronic hypertensive patients. MethodsIn the present cross-sectional study, 296 patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease were analyzed. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Left ventricular mass was quantified by CCTA and indexed to the body surface area (LVMi). Logistic regression analysis was used to identify predictors of LVH (men: ≥67.2 g/m2 and women: ≥54.7 g/m2). ResultsAmong our patient cohort (mean age: 59.4 ± 10.6, 44.9% female), the median LVM and LVMi were 115.5 [88.4–140.7] g and 58.4 [47.4–64.2] g/m2, respectively. Elevated BMI (OR = 1.04 CI: 1.01–1.10, p = 0.04) and cyclothymic affective temperament scores (OR = 1.06 CI: 1.00–1.12, p = 0.04) significantly increased the odds of LVH in multivariate logistic regression analysis. ConclusionAssessment of affective temperaments may allow for the identification of chronic hypertensive patients with elevated risk for LVH as a potential target for earlier primary intervention.

Association between affective temperaments and severe coronary artery disease

BackgroundAffective temperaments are regarded as subclinical manifestations of major mood disorders and cumulating evidence suggest their role in cardiovascular (CV) pathology. We wished to analyze associations between affective temperaments and severe coronary artery disease (CAD), as assessed by coronary computed tomography angiography (CCTA). Methods225 consecutive patients referred to CCTA due to suspected CAD were included. Medical history and demographic parameters were recorded and all patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). The severity and extent of CAD was evaluated by CCTA. Logistic regression analysis was used to identify predictors of severe CAD (≥70% luminal stenosis in ≥1 major coronary artery). ResultsAccording to multivariate logistic regression analysis, elevated hyperthymic affective temperament scores significantly decreased the odds of severe CAD (OR=0.92 CI: 0.84–1.00, p = 0.04), while independent positive associations were observed in case of dyslipidemia (OR=4.23 CI: 1.81–9.88, p = 0.001) and cyclothymic affective temperament scores (OR=1.12 CI: 1.02–1.23, p = 0.02). Furthermore, receiver operating curve (ROC) analysis was used to define ideal cutoff values. Hyperthymic temperament scores >11 (OR=0.41 CI: 0.19–0.90, p = 0.03), cyclothymic scores >7 (OR=3.23 CI: 1.35–7.76, p = 0.01) and irritable scores >6 (OR=2.79 CI: 1.17–6.69, p = 0.02) were also independently associated with severe CAD. LimitationsOur study was limited by the cross-sectional design and the self-report nature of the questionnaires. ConclusionsEvaluation of affective temperaments might help to identify patients with elevated risk for severe CAD and subsequent need for coronary intervention.

The association between accelerated vascular aging and cyclothymic affective temperament in women

ObjectiveAffective temperaments (depressive, anxious, irritable, hyperthymic, cyclothymic) are regarded as the biologically stable core of personality. Accumulating data suggest their relationship with cardiovascular diseases. However, there are currently limited data on the association of affective temperaments and accelerated vascular aging. The aim of our study was to evaluate the relationship between affective temperaments and vascular age, as assessed by coronary artery calcium scoring (CACS). MethodsIn our cross-sectional study, 209 consecutive patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD) were included. All patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). Vascular age was estimated using CACS and its difference from chronological age for each patient was calculated. Linear regression analysis was used to identify predictors of accelerated vascular aging in the entire cohort and in male and female sub-populations. ResultsBesides traditional risk factors, cyclothymic temperament score proved to be an independent predictor of accelerated vascular aging in women (β = 0.89 [95%CI: 0.04–1.75]), while this association was absent in men. ConclusionsOur results suggest that cyclothymic affective temperament is associated with accelerated vascular aging in women. Assessment of affective temperaments may potentiate more precise cardiovascular risk stratification of patients.

The association between early vascular aging and cyclothymic affective temperament

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Cardiovascular Imaging Research Group Background Affective temperaments (depressive, anxious, irritable, hyperthymic, cyclothymic) are regarded as the biologically stable core of personality, and accumulating data implies their relationship with cardiovascular diseases. There are currently limited data on the association of affective temperaments and early vascular aging. Purpose The aim of our study was to assess the potential relationship of affective temperaments and vascular age, as assessed by coronary CT. Methods In our current cross-sectional study, 209 patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD), were included. After the evaluation of medical history and demographic parameters, all patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). Vascular age was estimated using coronary artery calcium (CAC) score and we calculated its difference from chronological age for each patient. Linear regression analysis was applied to identify predictors of early vascular aging in the entire cohort and in male and female sub-populations, separately. Results The independent predictors of early vascular aging were female sex (B = -10.82 [95%CI: -15.30 – -6.33]), diabetes mellitus (B = 7.16 [95%CI: 1.20 – 13.12]) and dyslipidemia (B = -8.28 [95%CI: 3.94 – 12.62]). Further assessing gender differences, cyclothymic temperament score proved to be an independent predictor of early vascular aging in women (B = 0.89 [95%CI: 0.04 – 1.75]), while this association was absent in men. Conclusion Our results suggest that cyclothymic affective temperament contribute to early vascular aging in women.

P.43 The Association Between Early Vascular Aging and Cyclothymic Affective Temperament

ObjectivesAffective temperaments (depressive, anxious, irritable, hyperthymic, cyclothymic) are regarded as the biologically stable core of personality, and accumulating data implies their relationship with cardiovascular diseases. There are currently limited data on the association of affective temperaments and early vascular aging. The aim of our study was to assess the potential relationship of affective temperaments and vascular age, as assessed by coronary CT.MethodsIn our current cross-sectional study, 209 patients referred to coronary computed tomography angiography (CCTA) due to suspected coronary artery disease (CAD), were included. After the evaluation of medical history and demographic parameters, all patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) and the Beck Depression Inventory (BDI). Vascular age was estimated using coronary artery calcium (CAC) score and we calculated its difference from chronological age for each patient. Linear regression analysis was applied to identify predictors of early vascular aging in the entire cohort and in male and female sub-populations, separately.ResultsThe independent predictors of early vascular aging were female sex (B = −10.82 [95% CI: −15.30 – −6.33]), diabetes mellitus (B = 7.16 [95% CI: 1.20 – 13.12]) and dyslipidemia (B = −8.28 [95% CI: 3.94 – 12.62]). Further assessing gender differences, cyclothymic temperament score proved to be an independent predictor of early vascular aging in women (B = 0.89 [95% CI: 0.04 – 1.75]), while this association was absent in men.ConclusionsOur results suggest that cyclothymic affective temperament contribute to early vascular aging in women.

Evaluation of affective temperaments and arterial stiffness in different hypertension phenotypes.

Affective temperaments (depressive, anxious, irritable, hyperthymic, and cyclothymic) are stable parts of personality and describe emotional reactivity to external stimuli. Their relation to psychopathological conditions is obvious, but less data are available on their relationship with cardiovascular disorders. The aim of this study was to evaluate affective temperaments and hemodynamic and arterial stiffness parameters in healthy subjects (Cont), in white-coat hypertensive (WhHT) patients, and in non-resistant (non-ResHT) and resistant hypertensive (ResHT) patients. In this cross-sectional study, 363 patients were included: 82 Cont, 44 WhHT, 200 non-ResHT, and 37 ResHT. The patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), and arterial stiffness was examined with tonometry (PulsePen). Significant differences were found between the Cont, WhHT, non-ResHT and ResHT groups in pulse wave velocity (7.76 ± 0.96, 8.13 ± 1.39, 8.98 ± 1.25, and 10.18 ± 1.18 m/s, respectively, p < 0.05 between Cont and non-ResHT/ResHT; p < 0.05 between non-ResHT and ResHT). Cyclothymic affective temperament points (4 (2.25-8)) were higher (p < 0.05) in the ResHT group than in the Cont (2 (0-5)) and non-ResHT (3 (1-5)) groups. The cyclothymic temperament points of the WhHT group (4 (2-7)) were also higher than those in the Cont group. ResHT was independently associated with a cyclothymic scale score above 6 (beta = 2.59 (95% CI: 1.16-5.77)), an irritable scale score above 7 (beta = 3.17 (95% CI: 1.3-7.69)) and an anxious scale score above 9 (beta = 2.57 (95% CI: 1.08-6.13)) points. WhHT was also independently associated with cyclothymic scale scores above 6 points (beta = 2.378, 95% CI: 1.178-4.802). In conclusion, white-coat and ResHT patients have specific affective temperament patterns, and the evaluation of these patterns can help to understand the psychopathological background of these conditions.

Association between Cyclothymic Affective Temperament and Age of Onset of Hypertension.

Affective temperaments represent a biologically stable core of emotional reactivity and have previously been associated with hypertension and arterial stiffening. The age, when hypertension is initiated, is influenced by different factors, but the role of personality traits in this regard is not clarified yet. Our aim was to study the association between affective temperaments and the age at onset of hypertension. In this cross-sectional study, 353 patients were included. After the evaluation of history, patients completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire. We used linear regression analysis to identify predictors of the age of onset of hypertension in the whole cohort and in male and female subpopulations. The independent predictors of the age at onset of hypertension were male sex (B = −4.57 (95% CI = −1.40 to −7.74)), smoking (B = −4.31 (−7.41 to −1.22)), and positive family history (B = −6.84 (−10.22 to −3.45)). In women, cyclothymic temperament score was an independent predictor of the initiation of hypertension (B = −0.83 (−1.54 to −0.12)), while this association was absent in men. Besides traditional factors, cyclothymic affective temperament might contribute to the earlier initiation of hypertension in women.

EVALUATION OF THE ASSOCIATION BETWEEN THE AGE AT ONSET OF HYPERTENSION AND DIFFERENT AFFECTIVE TEMPERAMENTS

Objective: The age, when hypertension is initiated is influenced by different factors, but the role of personality traits in this regard is not clarified yet. Affective temperaments (depressive, cyclothymic, anxious, irritable and hyperthymic); which manifest early and are relatively stable in adulthood, have been associated with blood pressure and arterial stiffness. Our aim was to study the possible association between affective temperaments and the age at onset of hypertension. Design and method: In this cross-sectional study 357 patients were included (302 and 55 with chronic and new hypertension, respectively). After the evaluation of history, patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Predictors of the age at onset of hypertension and that of the early onset (under the age of 40) were studied. Results: The mean age of the subjects was 60.7 (±12) years. The independent predictors of the age at onset of hypertension were male sex (B = 4.67, 95%CI = 1.44–7.9 p = 0.005), smoking (B = -4.62, 95%CI = -7.77--1.46 p = 0.004) and positive family history (B = -6.94, 95%CI = -10.41--3.48, p < 0.001). High cyclothymic affective temperament score tended to be an independent predictor, however, the association was not significant (B = -0.48, 95%CI = -1.07–0.11, p = 0.110). When the subgroup of patients with early onset hypertension was studied (n = 73), male sex, smoking and positive family history remained independent predictors, however cyclothymic temperament score lost its predictive power (B = 0.010, p = 0.86). Conclusions: Besides traditional factors, cyclothymic affective temperament might contribute to the initiation of hypertension, but not in the early decades of life.

Motivational factors and negative affectivity as predictors of alcohol craving

Craving is thought to play an important role in alcohol use disorders. The recent inclusion of “craving” as a formal diagnostic symptom calls for further investigation of this subjective phenomenon with multiple dimensions. Considering that alcohol-dependent patients compensate negative physical/emotional states with alcohol, the aim of this study is to investigate alcohol craving and its correlation with drinking measures and affective personality dimensions. A sample of 135 alcohol-dependent patients (104 males and 31 females) was collected from a clinical setting. Subjects self-rated their cravings (Penn Alcohol Craving Scale) and the stage of change. Several personality scales were also administered. Craving was related to drinking status, abstinence time, age, and taking steps. After controlling for these conditions, psychological characteristics related to low self-concept, neuroticism, cyclothymic affective temperament, depression, and hostility were found to be predictors of craving in sober alcohol-dependent patients. Our results support craving as a component of the phenomenology of alcohol dependence and highlight the presence of unpleasant feelings as predictors of craving in sober alcohol-dependent patients without co-occurring psychiatric conditions. The predisposition to experience negative emotions may induce a stronger craving response and increase the likelihood of a first drink and a subsequent loss of control.

The Role of Parental Temperament Traits in Disruptive Behavioral Disorders of Children with ADHD

Introduction No study up to now investigated the role of parental temperament traits in disruptive behavioral disorders (DBD) of children with attention-deficit/hyperactivity disorder (ADHD). Objectives To determine the relationships between parent temperament characteristics and child DBD symptoms in children with ADHD. Methods The sample consisted of 542 treatment naive children with ADHD aged 6-17 years. All children had to be living with both biological mothers and fathers. The severity of ADHD and comorbid DBD were assessed via parent and teacher rated Turgay DSM-IV-Based Child and Adolescent Behavioral Disorders Screening and Rating Scale. Temperamental dimensions of mothers and fathers were measured by TEMPS-A. The association between parental ADHD and DBD was evaluated with two separate structural equation models. Results Relationships of parent ADHD and DBD symptoms were presented in Figures 1 and 2. Discussion This study showed a significant relationship between maternal depressive and paternal cyclothymic affective temperament and conduct disorder, and between maternal anxious and irritable, and paternal cyclothymic affective temperament and oppositional defiant disorder in children with ADHD. This study highlights that children with more severe behavioural symptoms are more likely to have a parent with certain temperament traits. Download : Download full-size image Download : Download full-size image

Troubles dissociatifs et troubles affectifs

The phenomenology of dissociative disorders may be complex and sometimes confusing. We describe here two cases who were initially misdiagnosed. The first case concerned a 61 year-old woman, who was initially diagnosed as an isolated dissociative fugue and was actually suffering from severe major depressive episode. The second case concerned a 55 year-old man, who was suffering from type I bipolar disorder and polyvascular disease, and was initially diagnosed as dissociative fugue in a mooddestabilization context, while it was finally a stroke. Yet dissociative disorders as affective disorder comorbidity are relatively unknown. We made a review on this topic. Dissociative disorders are often studied through psycho-trauma issues. Litterature is rare on affective illness comorbid with dissociative disorders, but highlight the link between bipolar and dissociative disorders. The later comorbidity often refers to an early onset subtype with also comorbid panic and depersonalization-derealization disorder. Besides, unipolar patients suffering from dissociative symptoms have more often cyclothymic affective temperament. Despite the limits of such studies dissociative symptoms-BD association seems to correspond to a clinical reality and further works on this topic may be warranted.

Personality and cardiovascular risk: Association between hypertension and affective temperaments—a cross-sectional observational study in primary care settings

Background: Affective temperaments can be considered the subclinical manifestations of affective disorders, which have a bidirectional relationship with cardiovascular diseases.Objectives: Aim of this study was to assess the role of affective temperaments in primary hypertension, which is the leading risk factor of cardiovascular morbidity and mortality.Methods: In total, 251 consecutive patients, including 179 patients being treated for primary hypertension with anti-hypertensives, with chronic disorders without diagnosed depression were enrolled in a primary care setting. Patients completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). Lifestyle-related risk factors, chronic diseases including cardiovascular complications were also recorded. Logistic regression analysis was used to determine the relationship of affective temperaments and lifestyle-related risk factors on hypertension.Results: Dominant cyclothymic temperament—with instability and rapid mood swings as main characteristics—had a significant association with hypertension (P = 0.006) even after the adjustment of correlation for known risk factors such as age, diabetes mellitus and obesity (OR: 11.88, 95%CI: 1.27–111.17). This association remained significant after controlling for the family wise error rate. The obtained adjusted P value was 0.024 at a 0.05 error rate.Conclusion: Results indicate that dominant cyclothymic affective temperament may be an additional risk factor in cardiovascular morbidity, and it may be worthy of further assessment to identify patients at risk and formulate a more individualized treatment approach.

Affective temperament, history of suicide attempt and family history of suicide in general practice patients

BackgroundUntreated major affective disorders are strongly associated with suicidal behaviour; however, clinical, psychological and psycho-social risk factors also play a contributory role. Personal history and family history of suicide are also important predictors of suicidal behaviours, and are also a powerful marker of current major depressive episode in general practice patients. Affective temperaments, which can be considered the subaffective manifestations of major mood disorders also show a specific pattern of association with suicidal behaviour. In the present study our aim was to investigate the association between affective temperaments, personal history of suicide attempts and family history of completed suicide in primary practice patients. MethodsFive hundred and nine patients from 6 primary care practices completed the TEMPS-A, and were assessed concerning self-reported history of personal or family suicide. ResultsWe found that among those answering questions concerning suicide, 9.1% reported a family history of suicide in first and second degree relatives and 4.8% had at least one prior suicide attempt. Among those giving a positive answer to both questions, those who had a positive family history had significantly more frequent suicide attempts (15.4% vs. 4.0%). Patients with prior suicide attempts had a significantly higher score on the cyclothymic and depressive, and those with positive family history of suicide had on cyclothymic and anxious subscales. LimitationsIn the present study, personal and family history of suicide was assessed retrospectively and in a self-report way. The cross-sectional nature of this study and the facts that no current psychiatric morbidity has been investigated and only the documented history of depressive and anxiety disorders have been detected limit the generalisability of this study. DiscussionWe found a significant relationship between depressive and cyclothymic affective temperament and personal history of suicide attempts, and between cyclothymic and anxious temperament and family history of completed suicide in first and second degree relatives. This is in line with previous findings showing a strong relationship between these affective temperaments and major mood episodes and that these temperaments are overrepresented among suicide attempters. Our findings also suggest that the presence of cyclothymic (and to lesser extent depressive) affective temperament in a patient with family history of completed suicide indicates a very high risk of suicidal behaviour.

Association of temperament with subjective sleep patterns

Background Emotional and cognitive functioning have been involved in insomnia etiology, and sleep disturbances are closely related to psychiatric disorders and personality traits. This study investigates the association of temperament with subjective sleep parameters. Methods In this web-survey, 5129 subjects (25.3% males) completed the Combined Emotional and Affective Temperament Scale (CEATS), which assesses emotional (fear, anger, drive and control) and affective (e.g. cyclothymic, hyperthymic) temperaments. Subjects also answered questions regarding subjective sleep parameters, psychiatric diagnosis, psychotropic medication intake and cigarette smoking. Results As control scores decreased, the later were the bed and the wake up time. Total sleep time was weakly associated with emotional temperaments. The higher the score of anger and the lower the score of control, the higher was the sleep-onset latency. As the anger score increased and the drive, fear and control scores decreased, the higher the number of nightly awakenings. The higher the drive and the control and the lower the anger scores, the better the sleep quality. For affective temperaments, depressives, labiles (related to ADHD) and cyclothymics (related to bipolar II disorders) go to bed and wake up later and have a worse profile regarding other sleep parameters. Hyperthymics and euthymics showed favorable sleep profiles. Limitations Sample included a significant number of subjects with psychiatric diseases and on psychotropic medication. Conclusion Dysregulated emotional activation (expressed as higher anger, and lower control and drive), as well as depressive, labile and cyclothymic affective temperaments were related to more dysfunctional sleep patterns.

Obsessive–compulsive disorder and cyclothymic temperament: An exploration of clinical features

Background: Bipolar disorder comorbidity in obsessive–compulsive disorder (OCD) has relevant implications on the symptomatological expression, complications and pharmacologic treatment of the disorder. Relatively few data exist on OCD comorbid with soft-bipolar forms. The aims of the study are to evaluate affective temperaments in patients with OCD and to analyze differences in socio-demographic and clinical characteristics according to the presence or absence of cyclothymic temperament. Methods: The sample consisted of 167 patients with a principal diagnosis of OCD (DSM-IV-TR). Affective temperaments have been evaluated through the Italian semistructured interview version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-I). Results: A total of 90 patients (53.9%) were diagnosed with a dominant affective temperament. Cyclothymic affective temperament (CT) was the most represented in the sample of OCD patients (19.2%). Patients with CT showed significant lower mean age at onset, higher scores at the HAM-A, more repeating compulsions, higher rates of eating disorder comorbidity, OCD spectrum disorder comorbidity and higher rates of Axis II comorbidity (particularly Cluster A). Limitations: Recruitment of OCD patients from a tertiary center. Absence of an investigation about treatment implications associated with cyclothymic temperament. Conclusions: Patients with OCD and CT could be more severe and complicated compared to patients without CT. Moreover, individuals with OCD spectrum disorders may be vulnerable to bipolarity. Systematic assessment of affective temperament is necessary to detect OCD with such a soft-bipolar comorbidity.

Cyclothymic temperament and major depressive disorder: A study on Italian patients

Background Classical authors had hypothesized that affective temperaments represent the subclinical manifestations of mood disorders: in particular, cyclothymic and hyperthymic temperaments have been considered as a subthreshold variant of bipolar disorder. The aim of our study is to test the presence of affective temperaments in a group of Italian patients with major depressive disorder (MDD), and to test the association between cyclothymic temperament and well-established validators of bipolar disorder diagnosis such as age at onset and family history of bipolar disorder. Methods Patients with diagnosis of major depressive disorder (DSM-IV-TR) were included in the study. Affective temperaments have been evaluated through the Italian semistructured interview version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-I). In order to improve the accuracy of family history and age at onset reports, close family members of the patients were also interviewed. Results 104 of patients included in the study have completed the temperament interview. 25.5% were diagnosed with a dominant affective temperament. Cyclothymic affective temperament was the most represented in the sample of MDD patients (12.3%); depressive, hyperthymic and irritable temperaments have been detected respectively in 7.5%, 2.8% and 2.8% of patients. Patients with CT showed a significantly lower age at onset of MDD than “pure” MDD patients (31.9 vs. 40.9 years; p = 0.049) and higher rates of family history of bipolar disorder in first degree relatives (15.4% vs. 0%; p = 0.001). Limitations The major limitation of this study was the lack of a group of bipolar depressives, which would have been useful in order to confirm the similarities of age at onset and bipolar family history with cyclothymic MDD. Conclusions Our data confirm previous reports in a sample of accurately screened patients with unipolar major depression: we found that patients with a cyclothymic temperament had an earlier age at onset and a higher family history for bipolar disorder than patients without any dominant affective temperament. Further research is needed to ascertain whether patients with “unipolar” cyclothymic MDD respond to mood stabilizers.