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18-07-2013 | Mental health | Article

Affective temperaments steer mood disorder disease course

Abstract

Free abstract

medwireNews: Temperamental state may predict the diagnosis, symptom presentation, and psychopathologic conditions of mood disorder patients, study findings show.

The results indicate a divergence between hyperthymic and depressive, cyclothymic, irritable, and anxious temperaments.

The study researchers report that in their study of 129 patients, hyperthymic temperament showed a preferential association with bipolar I disorder (BD-I) and bipolar disorder not otherwise specified diagnoses (BD-NOS), whereas depressive temperament was more frequent in patients with bipolar II disorder (BD-II) and major depressive disorder (MDD).

Anxious and depressive temperaments were more frequent in current depressive and mixed episodes compared with manic ones, while irritable temperaments were most frequent in mixed episodes and in patients suffering from alcohol dependence compared with nondependent patients.

The findings confirm the benefits of a “unitary” approach to considering temperamental mood states and full-blown mood disorders, says the team, led by Felice Iasevoli (University “Federico II” of Naples, Italy).

They believe that such an approach could “dramatically” improve evaluations on clinical presentation, as well as long-term outcome prediction, and treatment.

Indeed, in terms of clinical outcome, their findings showed that hyperthymic temperament conferred susceptibility to manic symptoms, but protected against depression and anxiety symptoms and the psychopathologic domains of somatization, depression, and interpersonal sensitivity.

By contrast, depressive, cyclothymic, irritable, and anxious temperaments correlated directly with virtually all psychopathology domains and with many mood-related symptoms.

“Our results may therefore provide a depiction of the specific symptoms and psychopathology that might be expected for each predominant affective temperament,” the team reports in the Journal of Affective Disorders.

“Since affective temperaments are considered stable traits, the characterization of predominant temperaments and temperament scores may be greatly helpful to predict clinical course even in acute relapsing patients, and may guide therapeutic choices.”

The researchers found, however, that this clinical divide according to temperament is not currently followed by temperament-targeted therapeutic interventions. Bipolar disorder patients in their study were treated with a mix of available drugs and there were no significant differences according to the underlying affective temperament.

“We suggest that a future step in research should be the characterization of pharmacological treatment efficacy and effectiveness based on temperamental states,” they comment.

“The evaluation of underlying temperaments may allow to develop targeted drug therapies and to avoid potentially unsafe or mood-switching agents,” the team explains.

medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013

By Lucy Piper, Senior medwireNews Reporter

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