Department of Psychiatry, University of Campania "L. Vanvitelli", 80132 Naples, Italy.
Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy.
Medicina (Kaunas). 2021 Jan 9;57(1):54. doi: 10.3390/medicina57010054.
Bipolar disorder (BD) is one of the most burdensome psychiatric illnesses, being associated with a negative long-term outcome and the highest suicide rate. Although affective temperaments can impact on BD long-term outcome, their role remains poorly investigated. The aims of the present study are to describe the clinical characteristics of patients with BD more frequently associated with the different affective temperaments and to assess the relation between affective temperaments and severity of clinical picture in a sample of patients with BD. A total of 199 patients have been recruited in the outpatients units of two university sites. Patients' psychiatric symptoms, affective temperaments, and quality of life were investigated through validated assessment instruments. Predominant cyclothymic and irritable temperaments are associated to higher number of relapses, poorer quality of life, higher rates of aggressive behaviors, and suicide attempts. Conversely, the predominant hyperthymic disposition was a protective factor for several outcome measures, including relapse rate, severity of anxiety, depressive and manic symptoms, suicidality, and earlier age at onset. One limitation of the present study is that the recruitment took place in two university sites; therefore, our findings cannot be fully generalized to the whole community of BD patients. Other limitations are the lack of a control group and the cross-sectional design of the study. The early identification of affective temperaments can help clinicians to identify those BD patients who are more likely to show a poor long-term outcome. An early screening of affective temperaments can be useful to develop targeted integrated pharmacological and psychosocial interventions.
双相情感障碍（BD）是最具负担性的精神疾病之一，与负面的长期结局和最高的自杀率有关。尽管情感气质可以影响 BD 的长期结局，但它们的作用仍未得到充分研究。本研究的目的是描述与不同情感气质相关的 BD 患者的临床特征，并评估情感气质与 BD 患者样本中临床症状严重程度之间的关系。 在两个大学地点的门诊单位共招募了 199 名患者。通过验证评估工具调查了患者的精神症状、情感气质和生活质量。 占主导地位的环性和易怒气质与更多的复发次数、较差的生活质量、更高的攻击性行为和自杀企图率相关。相反，占主导地位的高反应性气质是多个预后指标的保护因素，包括复发率、焦虑、抑郁和躁狂症状的严重程度、自杀意念和发病年龄较早。本研究的一个局限性是招募是在两个大学地点进行的，因此，我们的发现不能完全推广到整个 BD 患者群体。其他限制包括缺乏对照组和研究的横断面设计。 早期识别情感气质可以帮助临床医生识别那些更有可能出现不良长期结局的 BD 患者。对情感气质的早期筛查可以有助于制定有针对性的综合药物和心理社会干预措施。
