Akiskal H S, Hirschfeld R M, Yerevanian B I
Arch Gen Psychiatry. 1983 Jul;40(7):801-10. doi: 10.1001/archpsyc.1983.01790060099013.
Although characterologic constellations such as obsessionalism, dependency, introversion, restricted social skills, and maladaptive self-attributions are popularly linked to the pathogenesis of depressive disorders, the evidence in support of this relationship remains modest. Indeed, many of these attributes may reflect state characteristics woven into the postdepressive personality. Current evidence is strongest for introversion as a possible premorbid trait in primary nonbipolar depressions. By contrast, driven, work-oriented obsessoid, extroverted, cyclothymic, and related dysthymic temperaments appear to be the precursors of bipolar disorders. Other personalities, while not necessarily pathogenic in affective disorders, nevertheless may modify the clinical expression of affective disorders and their prognosis.
尽管诸如强迫观念、依赖、内向、社交技能受限和适应不良的自我归因等性格特征通常与抑郁症的发病机制相关，但支持这种关系的证据仍然有限。事实上，这些特征中的许多可能反映了抑郁发作后人格中形成的状态特征。目前的证据最有力地表明，内向是原发性非双相抑郁症可能的病前特征。相比之下，有干劲、以工作为导向的强迫型、外向、环性心境障碍及相关恶劣心境障碍的气质似乎是双相情感障碍的先兆。其他人格类型虽然不一定是情感障碍的致病因素，但可能会改变情感障碍的临床表现及其预后。
