Engström Christer, Brändström Sven, Sigvardsson Sören, Cloninger Robert, Nylander Per-Olof
Department of Neuroscience and Locomotion, University of Linköping, Sweden.
Bipolar Disord. 2003 Oct;5(5):340-8. doi: 10.1034/j.1399-5618.2003.00050.x.
The aim of this study was to examine whether personality i.e. temperament and character interacts with age of onset in bipolar disorder.
Bipolar patients were recruited among in- and outpatients from lithium dispensaries of northern Sweden. Patients were diagnosed according to DSM-IV criteria for bipolar disorder type I and II. Temperament and Character Inventory (TCI) was used for measuring personality. TCI was administered to 100 lithium treated bipolar patients and 100 controls.
Treatment response was significantly lower (p = 0.005) in patients with early onset compared with late onset. Family history (p = 0.013) and suicide attempts (p = 0.001) were also significantly more common in patients with early onset. Further, patients with early onset were significantly higher (p = 0.045) in the temperament factor harm avoidance (HA) than patients with late onset, but the difference was weak. Patients with early onset had more fear of uncertainty (HA2; p = 0.022) and were more shy (HA3; p = 0.030). Bipolar I patients showed similar results as those in the total bipolar group (I and II), with significantly higher HA (p = 0.019, moderate difference), HA2 (p = 0.015) and HA3 (p = 0.043) in patients with early onset compared with late onset. Bipolar II patients showed no differences between early and late age of onset but the groups are small and the results are therefore uncertain.
Early age of onset in bipolar disorder was correlated to an increase in severity, family history, poorer treatment response and poorer prognosis. Early onset was also correlated to personality.
本研究旨在探讨人格特质（即气质和性格）是否与双相情感障碍的发病年龄相互作用。
从瑞典北部锂盐门诊的住院和门诊患者中招募双相情感障碍患者。根据《精神疾病诊断与统计手册》第四版（DSM-IV）中I型和II型双相情感障碍的标准对患者进行诊断。使用气质和性格量表（TCI）来测量人格特质。对100名接受锂盐治疗的双相情感障碍患者和100名对照者进行了TCI测试。
早发型患者的治疗反应显著低于晚发型患者（p = 0.005）。早发型患者的家族史（p = 0.013）和自杀未遂（p = 0.001）也明显更为常见。此外，早发型患者在气质因子回避伤害（HA）方面显著高于晚发型患者（p = 0.045），但差异较小。早发型患者对不确定性的恐惧更强（HA2；p = 0.022）且更害羞（HA3；p = 0.030）。I型双相情感障碍患者的结果与双相情感障碍总组（I型和II型）相似，早发型患者的HA（p = 0.019，中度差异）、HA2（p = 0.015）和HA3（p = 0.043）显著高于晚发型患者。II型双相情感障碍患者在早发和晚发之间未显示出差异，但样本量较小，因此结果尚不确定。
双相情感障碍的早发与病情严重程度增加、家族史、治疗反应较差和预后不良相关。早发还与人格特质有关。
