Cassano G B, Akiskal H S, Perugi G, Musetti L, Savino M
University of Pisa, Italy.
J Psychiatr Res. 1992 Oct;26(4):257-68. doi: 10.1016/0022-3956(92)90032-j.
Collaboration between the University of Pisa, Italy, and the University of Tennessee, Memphis, U.S.A., on patients presenting with major depressive episodes (in the absence of nonaffective psychiatric illness) focused on the detection of depressive and hyperthymic temperaments. From our data on symptomatology, family history and course of 538 such patients, several findings emerge of cardinal relevance to genetic studies. Hyperthymic temperament, observed more commonly in men, appears as one pole of an attenuated form of manic-depressive illness. Thus, major depressives with this temperament have high rates of bipolar family history, even in the absence of hypomanic and manic episodes. The depressive temperament, more prevalent in women, is correlated with earlier onset and higher number of depressive episodes, greater severity of the Hamilton Rating Scale for Depression (HAM-D), as well as higher familial loading for mood disorders, compared with major depressives without this temperament. Building on Akiskal's latest model on the multifactorial origin of mood disorders, we submit that these temperamental dysregulations constitute the intermediate step between predisposing familial-genetic factors in affective illness and gender-related clinical expressions of mood disorders. The authors recommend that future high-risk prospective studies and genetic investigations should include measures of affective temperament.
意大利比萨大学与美国孟菲斯田纳西大学合作，针对患有重度抑郁发作（无非情感性精神疾病）的患者，重点研究抑郁性气质和轻躁狂性气质的检测。根据我们对538例此类患者的症状、家族史及病程数据，出现了一些对基因研究具有重要意义的发现。轻躁狂性气质在男性中更为常见，似乎是躁郁症弱化形式的一个极端。因此，具有这种气质的重度抑郁症患者即使没有轻躁狂和躁狂发作，双相情感障碍家族史的比例也很高。与没有这种气质的重度抑郁症患者相比，抑郁性气质在女性中更为普遍，与发病更早、抑郁发作次数更多、汉密尔顿抑郁量表（HAM-D）评分更高以及情绪障碍家族负荷更高相关。基于阿基斯卡尔关于情绪障碍多因素起源的最新模型，我们认为这些气质调节异常构成了情感疾病中易患家族遗传因素与情绪障碍性别相关临床表型之间的中间环节。作者建议未来的高危前瞻性研究和基因研究应纳入情感气质的测量。
