Akiskal Kareen K, Savino Mario, Akiskal Hagop S
International Mood Center, San Diego (USA) and French Depressive and Manic-Depressive Association, Rennes, France.
J Affect Disord. 2005 Mar;85(1-2):201-6. doi: 10.1016/j.jad.2004.08.003.
With the possible exception of cyclothymia in artists, there is a paucity of data in the literature on the temperament in different professions.
For this exploratory study, we sought to generate preliminary data on temperaments among psychiatric outpatients, including physicians (n=41), lawyers (n=30), managers and executives (n=35), industrialists (n=48), architects (n=27), journalists (n=34), and a mixed group of artists (n=48). They were compared with age, sex, social class, and affective disorder matched outpatients outside of these professions, drawn from the same clinical settings to serve as our Comparison Group (CG, n=120). We used an interview version of the Akiskal-Mallya criteria for temperaments. We finally used the DSM-III-R obsessive compulsive personality (OC traits).
Compared with the CG, lawyers and physicians had high rates of dysthymic temperament and OC traits. Managers, like lawyers and doctors, had high rates on OC traits but were different in being very low on cyclothymic and twice as hyperthymic than the CG was. Industrialists, who, by definition, were self-made, had even higher rates of hyperthymic traits. Both architects and artists seemed to have benefited from being cyclothymic (3-4 times higher than CG's); interestingly, architects had higher levels of OC traits, and artists were less obsessional than the CG was. Overall, among managers/executives and lawyers, 41% met criteria for affective temperaments, whereas the equivalent rate among the remainder was 77%.
Given that this is a chart review of existing clinical records, it was not possible to be blind to the profession of the patients. A mixed group of artists may have obscured differences among artists from different domains of art (e.g., poets vs. performing artists), and the same can be said of physicians (e.g., internists vs. surgeons). A disclaimer would be appropriate: Ours is not a study on eminence in the different professions but on the temperament and personality profiles that distinguish among them.
Despite the foregoing limitations and overlapping attributes in the different professions, they nonetheless emerged as having distinct temperamental and personality profiles. Dysthymic and obsessional attributes are notable in lawyers and physicians. We confirm the role of cyclothymia in artists and architects. The role of the hyperthymic temperament in managers, self-made industrialists, and journalists, to the best of our knowledge, is being reported for the first time. The role of cyclothymic and hyperthymic temperaments appears to be moderated by obsessional traits across the entire professional realm examined. In particular, artists' creative imagination appears "liberated" by low levels of OC traits, whereas among architects, relatively high levels of OC traits seem to contribute to the execution of their work. More tentatively, judging from the overall levels of affective temperaments in the remaining professions, on average, more of the managers/executives than self-made industrialists could be described as "colder" in temperament, and more of the physicians "warmer" than lawyers are. Journalists, as a group, appeared to possess the broadest representation of affective temperaments. The foregoing conclusions must be regarded as tentative, even hypothetical, in need of verification among professionals without major psychiatric disorders. Nonetheless, temperament profiles among psychiatrically ill professionals in the seven professional realms studies can help predict how they relate to their doctors, family members, colleagues, coworkers, and clients/patients. Such knowledge, in turn, can help the therapeutic process.
除了艺术家可能存在环性心境障碍外,文献中关于不同职业人群气质的数据较少。
在这项探索性研究中,我们试图获取精神科门诊患者中不同职业人群气质的初步数据,这些职业包括医生(n = 41)、律师(n = 30)、经理和高管(n = 35)、实业家(n = 48)、建筑师(n = 27)、记者(n = 34)以及一个混合的艺术家群体(n = 48)。将他们与来自相同临床环境、年龄、性别、社会阶层匹配且无情感障碍的其他职业门诊患者进行比较,作为我们的对照组(CG,n = 120)。我们使用了阿基斯卡尔 - 马利亚气质访谈版标准。最后,我们采用了《精神疾病诊断与统计手册第三版修订版》中的强迫型人格(OC特质)标准。
与对照组相比,律师和医生的心境恶劣气质和OC特质发生率较高。经理与律师和医生一样,OC特质发生率较高,但在环性心境气质方面非常低,且精力充沛气质是对照组的两倍。实业家,顾名思义是白手起家的,其精力充沛特质的发生率更高。建筑师和艺术家似乎都从环性心境气质中受益(比对照组高3 - 4倍);有趣的是,建筑师的OC特质水平更高,而艺术家的强迫倾向比对照组低。总体而言,经理/高管和律师中,41%符合情感气质标准,而其余职业人群的这一比例为77%。
鉴于这是对现有临床记录的图表回顾,无法对患者的职业视而不见。一个混合的艺术家群体可能掩盖了来自不同艺术领域(如诗人与表演艺术家)的艺术家之间的差异,医生群体(如内科医生与外科医生)也是如此。需要声明的是:我们的研究并非关于不同职业的卓越性,而是关于区分这些职业的气质和人格特征。
尽管存在上述局限性以及不同职业之间存在重叠属性,但它们仍呈现出独特的气质和人格特征。心境恶劣和强迫性属性在律师和医生中较为显著。我们证实了环性心境障碍在艺术家和建筑师中的作用。据我们所知,精力充沛气质在经理、白手起家的实业家和记者中的作用首次被报道。在整个研究的职业领域中,环性心境和精力充沛气质的作用似乎受到强迫特质的调节。特别是,艺术家的创造性想象力似乎因低水平的OC特质而“得到解放”,而在建筑师中,相对高水平的OC特质似乎有助于他们的工作执行。更初步地说,从其余职业情感气质的总体水平判断,平均而言,经理/高管比白手起家的实业家在气质上更“冷淡”,医生比律师更“热情”。作为一个群体,记者似乎拥有最广泛的情感气质表现。上述结论必须被视为初步的,甚至是假设性的,需要在没有重大精神疾病的专业人员中进行验证。尽管如此,在七个研究职业领域中,患有精神疾病的专业人员的气质特征有助于预测他们与医生、家庭成员、同事、同事以及客户/患者的关系。反过来,这些知识可以帮助治疗过程。