Cyclothymic temperament linked to depression recurrence in BD
MedWire News: Patients with bipolar disorder (BD) who have a cyclothymic temperament are more likely to experience depressive episode recurrences than their counterparts with other affective temperament types, results suggest.
However, there was no significant association between temperament type and recurrent episodes of mania, observe Kristine Nilsson (Aarhus University, Denmark) and team in the Journal of Affective Disorders.
To investigate whether temperament is associated with functional and affective outcomes in BD patients, the researchers studied 51 patients (35% men), aged a mean of 35 years, who were newly diagnosed with the mood disorder.
All of the participants were evaluated for affective temperament and function at baseline using the Temperament Evaluation of the Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A), and the Work and Social Adjustment Scale (WSAS).
The TEMPS-A contains five subscales measuring cyclothymic, dysthymic, irritable, hyperthymic, and anxious temperaments, while the WSAS measures impairments in work ability, home-management, social leisure activities, private leisure activities, and interpersonal relationships.
Over a follow-up period of 24 months, 17 (33%) patients experienced one or more affective recurrences. Of these, 13 (26%) experienced at least one depressive episode, eight (16%) experienced at least one hypomanic episode, and five (10%) experienced at least one manic episode.
The researchers found that patients with a cyclothymic temperament were significantly more likely to experience a depressive recurrence than those without this temperament type, at an odds ratio of 1.32. This associated risk increased (OR=1.45) after adjustment for medication nonadherence, age at onset, and annual frequency of past affective episodes.
The researchers also found that higher scores for cyclothymic temperament correlated significantly with greater functional impairment overall, as well as with impairment in three function domains: home-management, private leisure activities, and social leisure activities.
Dysthymic, irritable, hyperthymic, and anxious temperament types did not predict depressive recurrence, and the recurrence of mania was not predicted by any temperament type, the researchers note.
Nilsson and team conclude: "The present study suggests that the cyclothymic temperament is related to functional impairment and depressive recurrences. Thus, this temperament merits further investigation in terms of its causal effects on these illness outcomes."
They add: "On a broader level, the findings expand the theoretical perspective of affective temperaments by indicating their potential prognostic influences."
By Mark Cowen