Research Laboratory “Vulnerability to Psychotic disorders”, Department of Psychiatry, University Hospital of Monastir, 5000 Monastir, Tunisia.
J Affect Disord. 2011 Jul;132(1-2):285-8. doi: 10.1016/j.jad.2011.02.006. Epub 2011 Mar 4.
Recent studies have suggested that clinicians may under diagnose bipolarity in a substantial proportion of depressive patients, and proposed that affective temperaments particularly cyclothymic temperament (CT), may predict bipolarity in these patients. The objectives of this study were to assess CT in patients with recurrent depressive disorder (RDD) and to explore its associations with clinical predictors of bipolarity.
98 patients (43 men and 55 women, mean age=46.8±9.9years), followed for RDD according to DSM-IV-TR criteria, were recruited. CT was assessed using the Tunisian version of the TEMPS cyclothymic subscale with the threshold score of 10/21.
The mean score of CT was 6.5±5.2. One-third of patients (33.7%) had a CT score ≥10. These patients with high CT scores had significantly early age at onset of first depressive episode and high number of previous depressive episodes, and had more psychotic and melancholic features and suicidal ideations and attempts during the last depressive episode compared to patients with low CT scores. The multiple regression analysis showed an association between CT scores and psychotic, melancholic and atypical features and suicide attempts during the last depressive episode.
This is a cross-sectional study with a relatively small number of patients. The Tunisian version of the CT subscale was not yet validated.
CT was associated with some clinical predictive factors of bipolarity. These results suggest the relevance of the CT screening in RDD, considering the change of polarity risk and misdiagnosis of unipolar depression.
最近的研究表明，临床医生可能会在相当一部分抑郁患者中低估双相情感障碍的诊断，并提出情感气质，尤其是环性气质（CT），可能预测这些患者的双相情感障碍。本研究的目的是评估复发性抑郁障碍（RDD）患者的 CT，并探讨其与双相情感障碍临床预测因素的关系。
根据 DSM-IV-TR 标准，招募了 98 名（43 名男性和 55 名女性，平均年龄=46.8±9.9 岁）患有 RDD 的患者。使用经突尼斯修订的 TEMPS 环性亚量表评估 CT，阈值为 10/21。
CT 的平均得分为 6.5±5.2。三分之一的患者（33.7%）的 CT 得分≥10。这些 CT 得分较高的患者首发抑郁发作年龄较早，既往抑郁发作次数较多，在最后一次抑郁发作期间出现更多的精神病和忧郁特征以及自杀意念和尝试。多元回归分析显示 CT 评分与最后一次抑郁发作期间的精神病、忧郁和非典型特征以及自杀尝试有关。
这是一项横断面研究，患者数量相对较少。CT 亚量表的突尼斯版本尚未得到验证。
CT 与双相情感障碍的一些临床预测因素有关。这些结果表明，在 RDD 中，考虑到极性变化风险和单相抑郁的误诊，CT 筛查具有相关性。
