Department of Psychiatry, Tokyo Medical University, Tokyo, Japan.
Department of Psychiatry, Maezawa Hospital, Ashikaga, Japan.
Psychiatry Clin Neurosci. 2021 May;75(5):166-171. doi: 10.1111/pcn.13198. Epub 2021 Feb 5.
Early differential diagnosis between patients with major depressive disorder (MDD) and bipolar disorder (BD), and subsequently providing appropriate treatments are essential. There has been increased interest regarding the association between affective temperaments and mood disorder diagnosis. Our aim was to analyze the diagnostic validity of affective temperaments assessed by the short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A), in mood disorder patients.
Inpatients with MDD (n = 146) or BD (n = 128) completed the short version of TEMPS-A, and their depressive and manic symptom severities were evaluated. Data of MDD and BD patients were compared by univariable and multivariable analyses.
Of the five affective temperament dimensions, substantially higher hyperthymic, irritable, and cyclothymic temperament scores were found in BD patients than in MDD patients. Using a multivariable logistic regression model built using the severities of depressed and manic conditions, and the five affective temperament subscale scores as independent variables, we identified two factors statistically associated with BD diagnosis (anxious temperament and cyclothymic temperament). The recommended cutoff point for the 12 items evaluating cyclothymic temperament to differentiate BD from MDD was 8 or more 'True' items (sensitivity: 35.9%, specificity: 87.7%).
Our design was cross-sectional, and therefore, there was a possibility of longitudinal diagnostic conversion of patients from MDD to BD.
Cyclothymic and anxious temperaments on the short version of TEMPS-A, identified as diagnostic differentiating factors between MDD and BD, may play supplementary roles in the early identification of BD.
对单相抑郁障碍（MDD）和双相障碍（BD）患者进行早期鉴别诊断，并提供相应的治疗至关重要。目前人们对情感气质与心境障碍诊断之间的关系越来越感兴趣。本研究旨在分析由 Memphis、Pisa、Paris 和 San Diego 自动问卷短版（TEMPS-A）评估的情感气质对心境障碍患者的诊断价值。
MDD（n=146）或 BD（n=128）住院患者完成 TEMPS-A 短版评估，并对其抑郁和躁狂症状严重程度进行评估。采用单变量和多变量分析比较 MDD 和 BD 患者的数据。
在五个情感气质维度中，BD 患者的欣快气质、易激惹气质和环性气质得分明显高于 MDD 患者。使用包含抑郁和躁狂严重程度以及五个情感气质亚量表评分的多变量逻辑回归模型作为自变量，我们发现两个因素与 BD 诊断具有统计学相关性（焦虑气质和环性气质）。用于区分 BD 和 MDD 的 12 项环性气质评估的推荐截断点为 8 个或更多“真实”项（敏感性：35.9%，特异性：87.7%）。
我们的设计是横断面的，因此患者可能会从 MDD 向 BD 发生纵向诊断转换。
TEMPS-A 短版中的环性气质和焦虑气质可作为 MDD 和 BD 之间的鉴别诊断因素，可能在 BD 的早期识别中发挥补充作用。
