Hyperthymic Research Articles

Mediators in the Association Between Affective Temperaments and Suicide Risk Among Psychiatric Inpatients

Background: Affective temperaments have been shown to be related to psychiatric disorders and suicidal behaviors. Less is known about the potential contributory role of affective temperaments on suicide risk factors. In the present study, we investigated whether the effect of affective temperaments on suicide risk was mediated by other variables, such as hopelessness, mentalization deficits, dissociation, psychological pain, and depressive symptoms. Methods: Several assessment instruments, including the Mini International Neuropsychiatric Interview (MINI); the Temperament Evaluation of Memphis, Pisa, and San Diego Autoquestionnaire (TEMPS-A); the Beck Hopelessness Scale (BHS); the Gotland Male Depression Scale (GMDS); the Dissociative Experiences Scale (DES); the Psychological Pain Assessment Scale (PPAS); and the Mentalization Questionnaire (MZQ), were administered to 189 psychiatrically hospitalized patients (103 women, 86 men) in Rome, Italy. Results: In single-mediator models, hopelessness, depressive symptoms, and mentalization, but not psychological pain or dissociation, were significant mediators in the association between prevalent temperament and suicide risk. In a multiple-mediator model, a significant indirect effect was found only for depression. Results demonstrated that patients with negative temperaments reported higher suicide risk, psychological pain, hopelessness, and depression, and less mentalization than patients with no prevalent temperament or hyperthymic temperaments. Conclusions: Hopelessness, depression, and mentalization are all factors that mediate the relation between affective temperaments and suicide risk. Identifying factors that mediate the effects of affective temperamental makeup on suicide risk should enhance screening and intervention efforts.

Psychopathological characteristics and adverse childhood events are differentially associated with suicidal ideation and suicidal acts in mood disorders

BackgroundDepression is an important risk factor for suicide. However, other dimensions may contribute to the suicidal risk and to the transition from ideas to acts. We aimed to test the relative involvement of hopelessness, temperament, childhood trauma, and aggression in suicide risk in a large sample of patients with mood disorders. MethodsWe assessed 306 patients with major depressive and bipolar disorders for clinical characteristics including hopelessness, temperament, childhood trauma, and aggression. We tested their associations with suicidal ideation and acts using standard univariate/bivariate methods, followed by multivariate logistic regression models. ResultsIn multivariate analyses, the loss of expectations subscore of the hopelessness scale was associated with lifetime suicidal ideation but not suicide attempt. Childhood emotional abuse, severity of current depression, and female gender were associated with lifetime suicide attempts, whereas hyperthymic temperament was protective. Only hyperthymic temperament differentiated patients with a history of suicidal ideas vs. those with a history of suicide attempt. ConclusionsFindings support the association of hopelessness with suicidal ideation and point to considering in suicidal acts not only depression, but also childhood emotional abuse, hyperthymic temperament, and gender.

Health-related quality of life in multiple sclerosis: temperament outweighs EDSS

BackgroundThe influence of personality on health-related quality of life in patients with multiple sclerosis has been the focus of previous studies showing that introversion and neuroticism were related with reduced health related quality of life. However, no data exist on the impact of temperament on quality of life in this patient group.MethodsBetween April 2014 and March 2016 139 multiple sclerosis patients were recruited from a specialized outpatient clinic of the general hospital of Vienna. Health-related quality of life was measured by “The Multiple Sclerosis International Quality of Life Questionnaire (MusiQol)”, temperament by “Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Questionnaire – Münster version” (briefTEMPS-M), and disability by the “Expanded disability status scale”. All patients underwent a diagnostic psychiatric semi-structured interview (MINI).ResultsKnown predictors (like disease duration, EDSS, psychiatric co-morbidities, immunomodulatory treatments) explain the proportion of variation in the outcome of MusiQol global index score in 30.9% in multi-variable linear regression analysis. It increased respectively to 40.3, 42.5, and 45.8% if adding the depressive, cyclothymic, or hyperthymic temperament to the list of variables. An increase of depressive and cyclothymic temperament scores significantly reduced global index score of MusiQol (p = 0.005, p = 0.002, respectively), while the hyperthymic temperament significantly raised it (p < 0.001).ConclusionIn MS patients, the depressive and cyclothymic temperament predict a lower and hyperthymic temperament an increased health-related quality of life, independent of current disability status, immunomodulatory treatments, and affective co-morbidities.

The relationship between affective temperament and suicide attempt, clinical history and current subclinical symptoms in bipolar disorder

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.

Coping with the New Era: Noise and Light Pollution, Hperactivity and Steroid Hormones. Towards an Evolutionary View of Bipolar Disorders

Human population is increasing in immense cities with millions of inhabitants, in which life is expected to run 24 hours a day for seven days a week (24/7). Noise and light pollution are the most reported consequences, with a profound impact on sleep patterns and circadian biorhythms. Disruption of sleep and biorhythms has severe consequences on many metabolic pathways. Suppression of melatonin incretion at night and the subsequent effect on DNA methylation may increase the risk of prostate and breast cancer. A negative impact of light pollution on neurosteroids may also affect mood. People who carry the genetic risk of bipolar disorder may be at greater risk of full-blown bipolar disorder because of the impact of noise and light pollution on sleep patterns and circadian biorhythms. However, living in cities may also offers opportunities and might be selective for people with hyperthymic temperament, who may find themselves advantaged by increased energy prompted by increased stimulation produced by life in big cities. This might result in the spreading of the genetic risk of bipolar disorder in the coming decades. In this perspective the burden of poor quality of life, increased disability adjusted life years and premature mortality due to the increases of mood disorders is the negative side of a phenomenon that in its globality also shows adaptive aspects. The new lifestyle also influences those who adapt and show behaviors, reactions and responses that might resemble the disorder, but are on the adaptive side.

Richard Kogan to Explore the Music, Mind of Leonard Bernstein

Back to table of contents Previous article Next article Annual MeetingFull AccessRichard Kogan to Explore the Music, Mind of Leonard BernsteinNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:12 Feb 2018https://doi.org/10.1176/appi.pn.2018.2b19AbstractPsychiatrist and pianist Richard Kogan, M.D., will honor the 100th anniversary of Bernstein’s birth and showcase a talent who made his career in New York.“It would not be going out on a limb to say Leonard Bernstein is the greatest all-around musician America has ever produced,” Richard Kogan, M.D., a clinical professor of psychiatry at Weill Cornell Medical College, recently told Psychiatric News. Jack MitchellBernstein was, after all, the true epitome of the “creative genius,” said Kogan, who is also the artistic director of the Weill Cornell Music and Medicine Program and co-director of the Weill Cornell Human Sexuality Program. Bernstein was an impassioned music conductor, a gifted pianist, and one of the foremost music lecturers in history. Bernstein’s memorable contributions as a composer can be heard in classical concert halls and Broadway theaters and on the Hollywood silver screen.As with many creative luminaries, though, Bernstein also dealt with psychological issues that affected his daily living but also became important elements of his works. The conflict of inner turmoil versus external success will be explored in Kogan’s session at APA’s Annual Meeting titled “West Side Story: The Mind and Music of Leonard Bernstein.”The session will honor the 100th anniversary of Bernstein’s birth and showcase a talent who made his career in New York City and whose life very much reflected the fast pace and brashness of the city.As in previous years, Kogan’s special session will combine insightful discussion of Bernstein’s life with musical selections from his diverse catalog of material. Kogan, who in addition to being a psychiatrist is an award-winning pianist, will perform well-known numbers from “West Side Story” and “On the Town,” as well as lesser-known pieces from Bernstein’s classical library.Richard Kogan, M.D., is a graduate of Juilliard and Harvard Medical School. He has gained international renown for his lecture/concerts that explore the impact of psychological forces on the creative output of great composers.The fact that his popular works were more well received than his classical music was a significant source of tension for Bernstein, Kogan noted. “Bernstein had a hyperthymic temperament; he was uninhibited and sociable and had an overwhelming amount of exuberance and energy,” Kogan said. “Normally, though, composing is a solitary affair, and that posed a continual challenge during his life.”That’s why Bernstein, despite a personal desire to be remembered in the same vein as figures like Mozart, was frequently drawn to the stage and screen. In these venues, composing music is a collaborative venture between musicians, lyricists, choreographers, and performers, Kogan said. Bernstein’s hyperthymic personality also came through vividly when he was conducting. Bernstein was known for his animated conducting style (which on at least one occasion led him to fall off the conductor’s stand). Audiences loved it, as did the orchestral musicians, but over time Bernstein became concerned that his rising fame as a conductor was overshadowing his compositions.Bernstein faced other challenges not related to his creative genius, Kogan noted. Significant among these was Bernstein’s sexuality. While married for more than 25 years to actress Felicia Montealegre, Bernstein engaged in numerous rumored and documented homosexual encounters. “He lived such a complex and fascinating life, and I hope attendees can get some sense of that life through this lecture,” Kogan told Psychiatric News. ■ ISSUES NewArchived

Relationship between anxious temperament and harm avoidance in medical students and staff.

In order to resolve the equivocal relationship between anxious temperament rated by the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A) and harm avoidance rated by the Temperament and Character Inventory (TCI), the present study aimed to investigate whether the anxious temperament scale and the harm avoidance scale are significantly associated with adjustment of relevant factors. Our hypothesis was that anxious temperament might be associated with harm avoidance. From the database of our previous studies, the data of 111 healthy subjects who had both TCI and TEMPS-A scores were extracted for the present study. Two multiple regression analyses were performed: one to predict variance in anxious temperament scores without and with harm avoidance scores, and relevant factors; and another to predict variance in harm avoidance scores without and with anxious temperament scores, and relevant factors. Anxious temperament was significantly and positively associated with depressive temperament, irritable temperament, and Hamilton Rating Scale for Depression whereas harm avoidance was significantly and negatively associated with hyperthymic temperament, novelty seeking, persistence, and self-directedness, although both were significantly and positively associated with each other. These findings support our hypothesis and suggest that anxious temperament may have 'depressive proneness' whereas harm avoidance may have 'passive proneness.'

The impact of affective temperaments on clinical and functional outcome of Bipolar I patients that initiated or changed pharmacological treatment for mania

BackgroundAffective temperaments have been shown to impact on the clinical manifestations and the course of bipolar disorder. We investigated their influence on clinical features and functional outcome of manic episode. MethodIn a naturalistic, multicenter, national study, a sample of 194 BD I patients that initated or changed pharmacological treatment for DSM-IV-TR manic episode underwent a comprehensive evaluation including briefTEMPS-M, CTQ, YMRS, MADRS, FAST, and CGI-BP. Factorial, correlation and comparative analyses were conducted on different temperamental subtypes. ResultsDepressive, cyclothymic, irritable and anxious temperaments resulted significantly correlated with each other. On the contrary, hyperthymic temperament scores were not correlated with the other temperamental dimensions. The factorial analysis of the briefTEMPS-M sub-scales total scores allowed the extraction of two factors: the Cyclothymic-Depressive-Anxious (Cyclo-Dep-Anx) and the Hyperthymic. At final evaluation Dominant Cyclo-Dep-Anx patients reported higer scores in MADRS and in CTQ emotional neglect and abuse subscale scores than Dominant Hyperthymic patients. The latter showed a greater functional outcome than Cyclo-Dep-Anx patients. ConclusionsAffective temperaments seem to influence the course of mania. Childhood emotional abuse and neglect were related to the cyclothymic disposition. Cyclothymic subjects showed more residual depressive symptoms and Hyperthymic temperament is associated with a better short-term functional outcome.

Suicidal Risk and Affective Temperaments, Evaluated with the TEMPS-A Scale: A Systematic Review

Among risk factors for suicidal behavior, there is growing interest in associations with stable affective temperament types, particularly based on assessment with the TEMPS-A self-rating scale. As research on this topic has not been reviewed systematically, we synthesized relevant, reported research findings. Systematic searching identified peer-reviewed reports pertaining to associations of suicidal behavior or ideation with affective temperament types evaluated with TEMPS-A. We summarized available findings and applied quantitative meta-analytic methods to compare scale scores in suicidal versus nonsuicidal subjects. In 21 of 23 TEMPS-A studies meeting inclusion criteria, anxious, cyclothymic, depressive, or irritable temperament scores were significantly higher with previous or recent suicide attempts or ideation in both psychiatric and general population samples compared to nonsuicidal controls, whereas hyperthymic temperament scores were lower in 9 of 11 reports. These findings were synthesized by random-effects meta-analyses of standardized mean differences in TEMPS-A temperament scores in suicidal versus nonsuicidal subjects. Associations ranked: depressive ≥ irritable > cyclothymic > anxious > hyperthymic (negative). Affective temperaments, especially depressive and irritable, were strongly associated with suicidal risk, whereas hyperthymic temperament appeared to be protective.

Étude des tempéraments affectifs chez des patients épileptiques en Tunisie

PurposeEpilepsy is a chronic neurological disorder that is associated with an increased risk for psychopathology. Depression is the most common comorbid psychiatric condition in epilepsy, with often atypical clinical manifestations, including symptoms of irritability and anxiety. Temperament refers to biologically based characteristic patterns of emotional reactivity and self-regulation. In early studies, specific temperamental factors have been shown to be risk factors for depression symptoms in adult epilepsy patients. Thus, determining the affective temperament profile of epilepsy patients has important clinical implications especially in identifying those patients most at risk of developing mood disorders. However, very few studies of temperament in epilepsy patients have yet been published. The purpose of this study was to measure depression symptoms and severity, and to assess temperament in adult epilepsy patients, in comparison with control subjects; and to evaluate among the group of epilepsy patients the relationships between affective temperament types, sociodemographic profiles, clinical characteristics, and symptoms of depression. MethodParticipants were recruited from the Neurology Outpatient Department of National Institute of Neurology in Tunis, Tunisia. The study sample comprised 53 epilepsy outpatients (males=33, females=20) over the age of 16years with a confident diagnosis of epilepsy. Matched controls (based on sex and age) included 52 healthy individuals. The Hamilton Rating Scale for Depression (HRSD) and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego-Auto questionnaire (TEMPS-A) was used in their Arabic versions to measure depression and temperament respectively. The questionnaires were administered individually. Data were analyzed using SPSS software, version 18. ResultsFindings indicated that patients with epilepsy had higher scores on depression and temperament scales than healthy controls. With respect to temperaments, hyperthymic temperament had the highest score in patients and controls, followed by anxious, cyclothymic, and depressive temperaments. Irritable temperament had the lowest average score. No significant associations were found between sociodemographic profile, illness characteristics and temperament scores in patients with epilepsy. An extremely strong association was found between depressive, cyclothymic, irritable and anxious temperament scores and the HRSD scale among epilepsy patients. These findings confirm literature data about affective temperament profile in epilepsy patients that put them at greater risk for mood disorders. ConclusionResults underscore the importance of assessment of affective temperaments among epilepsy patients, which could play a key role in defining the sub-group at high risk for developing mood disorders and improving, consequently, diagnostic and therapeutic approaches to patients suffering from both epilepsy and depression. More extended studies may help validate the concepts of profile temperaments in epilepsy and their relation to depressive vulnerability.

Reward Dysfunction in the Manic Spectrum: Unable to Win? The Use of Biographical Information to Refine Neurobiological Modeling.

The manic spectrum is thought to be characterized by a hypersensitive biobehavioral reward system, the behavioral activation system. Evidence for this framework comes from questionnaire-based, self-report data collected in cross-sectional and prospective studies of mania, mania in remission, and proneness to hypomania, and from functional neuroimaging investigations of brain reward circuit activity during incentivized choice protocols. Although heightened reward anticipation is consistently documented, the status of later goal attainment activity, hedonic responses, and satiety reactions is less clear. This report examines the status of such reward receipt processes as they operate in the manic spectrum. A case report of a typical subject with bipolar II disorder with a hyperthymic temperament is presented using longitudinal, biographical data. Diminished reward receipt, pleasure, and satiety were demonstrated indicating impaired hedonic processing in hyperthymic temperament. This impairment indicates a dissociation between early, intensified reward pursuit processes and later, blunted, reward attainment activity. The experience and neural correlates of hedonic processing may be impaired in the manic spectrum. Possible mechanisms for this impairment and its dissociation from the earlier stage of reward processing characterized by hyperactive reward pursuit are considered. Clinical reports and longitudinal, life-based follow-up can provide important data to supplement more experimentally based neurobiological models of reward dysfunction in bipolar disorders.

The association of affective temperaments and bipolar spectrum psychopathology: An experience sampling study

Affective temperaments are trait-like expressions of affect that underlie mood psychopathology. Numerous studies have examined affective temperaments in laboratory-based studies; however, few have examined the expression of these temperaments in daily life. The present study examined affective temperaments and their associations with the expression of bipolar spectrum characteristics in daily life using experience sampling methodology. Young adults (n = 290) completed the TEMPS-A and were signaled eight times daily for 1 week to complete smartphone surveys assessing affect, cognition, and behavior. Hyperthymic temperament was associated with positive affect, sense of self, and success. In contrast, cyclothymic/irritable temperament was associated with negative affect, impulsivity, negative sense of self, and difficulty concentrating. Those high in cyclothymic/irritable temperament were especially reactive to the experience of stress. Affective temperaments were differentially associated with the expression of bipolar spectrum psychopathology in daily life. The findings offer validation of the TEMPS-A, as well as the adaptive and maladaptive characteristics of hyperthymic and cyclothymic/irritable temperaments.

Affective temperaments during pregnancy and postpartum period: a click to hyperthymic temperament

Background: Pregnancy and postpartum periods are the main reproductive periods during which women experience mood disorders. Affective temperaments are known antecedents of mood disorders and their importance is increasing in time for early diagnosis and determining risky groups. But data about affective temperaments during perinatal period is limited. Methods: Women during pregnancy and perinatal period and healthy controls who are not in perinatal period are included in the study. 83 pregnant women in 1st trimester, 94 pregnant women in 2nd trimester and 115 pregnant women in 3rd trimester; 32 women in 1st month postpartum and 89 women in 2nd month postpartum; and 88 healthy non-pregnant women with similar ages were evaluated regarding their temperament evaluation of Memphis, Pisa, Paris and San Diego auto-questionnaire (TEMPS-A) scores. Results: Women in perinatal period had higher scores of hyperthymic temperaments than the control group. Women in the 2nd month of postpartum period had also higher anxious temperament scores. And women in the second trimester had the highest hyperthymic temperament scores. Conclusion: Pregnancy and postpartum periods correlate with hyperthymic temperament characteristics in women without active psychiatric diagnosis. Future studies will help to understand if this is a mental quietness or increased risk for bipolarity.

Interpersonal sensitivity mediates the effects of child abuse and affective temperaments on depressive symptoms in the general adult population.

BackgroundRecent studies have suggested that multiple factors interact with the onset and prognosis of major depressive disorders. In this study, we investigated how child abuse, affective temperaments, and interpersonal sensitivity are interrelated, and how they affect depressive symptoms in the general adult population.Subjects and methodsA total of 415 volunteers from the general adult population completed the Patient Health Questionnaire-9, the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire version, the Child Abuse and Trauma Scale, and the Interpersonal Sensitivity Measure, which are all self-administered questionnaires. Data were subjected to structural equation modeling (Mplus), and single and multiple regression analyses.ResultsThe effect of child abuse on depressive symptoms was mediated by interpersonal sensitivity and 4 affective temperaments, including depressive, cyclothymic, anxious, and irritable temperaments. In addition, the effect of these temperaments on depressive symptoms was mediated by interpersonal sensitivity, indicating the indirect enhancement of depressive symptoms. In contrast to these 4 temperaments, the hyperthymic temperament did not mediate the effect of child abuse on depressive symptoms; its effect was not mediated by interpersonal sensitivity. However, a greater hyperthymic temperament predicted decreased depressive symptoms and interpersonal sensitivity, independent of any mediation effect.LimitationsBecause this is a cross-sectional study, long-term prospective studies are necessary to confirm its findings. Therefore, recall bias should be considered when interpreting the results. As the subjects were adults from the general population, the results may not be generalizable towards all patients with major depression.ConclusionThis study suggests that child abuse and affective temperaments affect depressive symptoms partly through interpersonal sensitivity. Interpersonal sensitivity may have a major role in forming the link between abuse, affective temperament, and depression.

Affective Temperaments, Mood, and Insomnia Symptoms in a Nonclinical Sample

ABSTRACTObjective: The aim of the study was to understand the relationship between affective temperaments and insomnia symptoms and to examine mood state as a mediator in this relationship. Participants: The sample consisted of 659 adults (428 women and 231 men), aged 18–77 years old, derived from a nonclinical population. Methods: Affective temperaments were assessed using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A). Mood was measured using the UWIST Mood Adjective Checklist (UMACL). Insomnia was evaluated by the Athens Insomnia Scale. Results: We found positive correlations among anxious, cyclothymic, depressive, and irritable affective temperaments and insomnia symptoms. Negative correlation with insomnia symptoms was found for hyperthymic temperament. Energetic arousal and tense arousal, as mood dimensions, positively correlated with insomnia symptoms. Hierarchical regression analysis indicated that anxious, cyclothymic, and hyperthymic temperaments were significant predictors of insomnia symptoms. Mediation analyses indicated that anxious, cyclothymic, and hyperthymic temperaments affected insomnia symptoms, both directly and indirectly, through energetic arousal as a mediator. Conclusions: The results showed a relationship between affective temperaments and insomnia symptoms and included the role of energetic arousal, a mood state dimension, as a mediator.

Alcohol use and bipolar disorders: Risk factors associated with their co-occurrence and sequence of onsets

BackgroundLittle is known about the sequence of onsets in patients affected by comorbid alcohol use and bipolar disorder. This study examines the risk factors associated with their co-occurrence and order of onset. MethodThe demographic, clinical, and temperament characteristics as well as the course of illness were analyzed within our sample of 1090 DSM-IV bipolar I manic patients. Our sample was categorized according to the presence of comorbid alcohol use disorder and the sequence of onsets of bipolar and alcohol use disorders i.e., alcohol first (AUD-BD) and bipolar first (BD-AUD). ResultsRegression analyses revealed that alcohol use disorder (52.5%) was associated with the male gender, additional substance use disorders, as well as an irritable and a hyperthymic temperament. The AUD-BD group (6.6%) was older than the BD-AUD group (45.8%) and showed higher rates of comorbid sedative use, organic, and anxiety disorders with higher levels of irritable temperament, and a bipolar subtype characterized by depressive polarity at onset. The BD-AUD group had high levels of hyperthymic temperament with higher rates of comorbid stimulant use disorder and a manic polarity at onset. ConclusionsIn the AUD-BD group, alcohol might have been used to reduce stress and tension caused by the presence of an irritable temperament as well as anxious and organic disorders, leading to first depressive episode. In the BD-AUD group, stimulant use might have triggered the first manic episode, and alcohol abuse result from mania severity.

Re-analysis of the association of temperature or sunshine with hyperthymic temperament using lithium levels of drinking water

BackgroundThe Japanese archipelago stretches over 4000km from north to south and has four large islands: Hokkaido, Honshu, Shikoku, and Kyushu. Previously, using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A), we compared the hyperthymic scores of residents in Sapporo, Obihiro, Takaoka, Koshigaya, and Oita cities (which are located at latitudes of 43°N, 42°N, 36°N, 36°N and 33°N with various combinations of ambient temperament and sunshine in Japan, respectively). We found that latitude predicted significant variance in hyperthymic temperament, and that ambient temperature, but not sunshine, significantly affected hyperthymic temperament scores. However, the analysis failed to consider the effects of naturally occurring low-dose lithium on temperament. MethodsIn addition to the TEMPS-A data previously collected, we measured lithium levels of the five cities. The effect of temperature, sunshine, and lithium levels on hyperthymic temperament was analyzed for the five cities. ResultsA stepwise multiple regression analysis revealed that lithium levels as well as latitude, but not temperature or sunshine, predicted significant variance in hyperthymic temperament scores. Hyperthymic temperament scores were significantly and positively associated with lithium levels whereas they were significantly and negatively associated with latitude. LimitationsThe light, temperature, lithium exposure that residents actually received was not measured. The number of regions studied was limited. The findings might not be generalized to residents across Japan or other countries. ConclusionsThe present findings suggest that lithium in drinking water may positively maintain hyperthymic temperament, and that latitude may negatively maintain it.

ARNTL, CLOCK and PER3 polymorphisms – links with chronotype and affective dimensions

ABSTRACTRecently, seven single nucleotide polymorphisms (SNPs) of ARNTL, TIM and PER3 genes were found associated with affective temperaments in bipolar disorder patients. This study aimed to test whether a) the same associations appear in a non-clinical sample; b) the SNPs are related to other affective dimensions; c) the SNPs underpin the associations between chronotype and affective temperaments/dimensions. Three hundred thirty-eight university students completed the Temperament Scale of Memphis, Pisa, Paris and San Diego Auto-questionnaire, the Centre for Epidemiological Studies Depression Scale, the Perceived Stress Scale, the General Health Questionnaire, the Seasonal Pattern Assessment Questionnaire and the Composite Scale of Morningness. Seven SNPs of the ARNTL, TIM and PER3 genes were genotyped. According to nominal significance, ARNTL rs7107287 was associated with a cyclothymic temperament, depressive and stress symptoms, general mental health and perceived negative impact of seasonality, while TIM rs10876890 was associated with a hyperthymic temperament, and the TIM rs2291738 was associated with chronotype. Different SNPs were related to chronotype and affective temperaments/dimensions, and therefore, they seem to not underpin relationships between chronotype and affective dysfunction, that is, in the present study, eveningness was related to dysthymic, cyclothymic and irritable temperaments, more symptoms of depression, stress, worse mental health and a negative impact of seasonality, while morningness was related to hyperthymic temperament. The SNPs associations need further replication given that they did not achieve Bonferroni criteria of significance accounting for the number of polymorphisms considered and tests conducted.

Affective Temperaments in Parents of Children with Attention Deficit Hyperactivity Disorder.

The objective of this study was to investigate affective temperaments of parents of children with ADHD and the relationship between ADHD and affective temperaments. The children diagnosed with ADHD were evaluated with a structured interview and the Turgay DSM-IV-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was filled by parents. Then parents were evaluated by a structured clinical interview for DSM-IV (SCID-I), and those with no diagnosis of psychiatric disorder (in the past and at the time of the study) were included to the study. The Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire was used to evaluate affective temperaments of parents. A control group of parents who has no children with ADHD was applied the same evaluation protocol. The study was conducted with 123 parents (66 mothers, 57 fathers) of 66 children with ADHD and 119 control parents (65 mothers, 54 fathers) of 71 children without ADHD. Affective temperament scores of parents of children with ADHD were significantly higher than those of the control group. When the scores of mothers and fathers were compared separately, mothers had higher scores in all temperaments except hyperthymic temperament, and fathers had higher scores in all temperaments except anxious temperament in the ADHD group. Additionally, the T-DSM-IV-S attention deficit and hyperactivity/impulsivity scores of children were moderately correlated with most of the affective temperaments scores of their parents. There is a relationship between ADHD and affective temperaments. Further studies are needed to understand the etiology, strength, and nature of this relationship.

Affective temperaments in anorexia nervosa: The relevance of depressive and anxious traits

BackgroundAffective temperaments have been so far understudied in anorexia nervosa (AN) despite the relevance of personality and both affective and anxious comorbidity with regard to vulnerability, course, and outcome of this deadly disorder. MethodsNinety-eight female inpatients diagnosed with AN and 131 healthy controls (HCs) were enrolled in this study and completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) in addition to assessments of eating psychopathology, depression, and anxiety. ResultsAN patients and HCs differed in all affective temperaments. The diagnostic subtypes of AN differed as well with binge-purging individuals being more cyclothymic and anxious than those with restricting-type AN. TEMPS-A scores correlated with body mass index and eating psychopathology but not with duration of illness. Concerning comorbidity, grater scores on the depressive and lower scores on the hyperthymic temperaments were found in depressed patients. Those who had either an anxious or irritable temperament were significantly more diagnosed with an anxious disorder than those who did not show this temperament. When logistic regression was performed, high depressive/low hyperthymic and high irritable/anxious traits resulted to be associated with depressive and anxious comorbidity, respectively, independently of confounding factors. LimitationsCross-sectional design, some patients on medications, few baseline clinical differences between diagnostic subtypes, no other personality assessments. ConclusionsAn affective continuum strongly associated with mood and anxious comorbidity emerged in AN. Such an evaluation could have several research and clinical implications given the need of improving treatment individualization and early interventions for such a complex disorder.