RESUMO
BACKGROUND: The aim of this study was to investigate the role of hyperthymic temperament in suicidal ideation between a sample of patients with affective disorders (unipolar and bipolar). METHOD: We investigated affective disorders outpatients (unipolar, bipolar I, II and NOS) treated in eleven participating centres during at least a six-month period. DSM-IV diagnosis was made by psychiatrists experienced in mood disorders, using the corresponding modules of the Mini International Neuropsychiatric Interview (MINI). In addition, bipolar NOS diagnoses were extended by guidelines for bipolar spectrum symptoms as proposed by Akiskal and Pinto in 1999. Thereby we also identified NOS III (switch by antidepressants) and NOS IV (hyperthymic temperament) bipolar subtypes. All patients completed the Beck Depression Inventory (BDI). We screened a total sample of 411 patients (69% bipolar), 352 completed all the clinical scales without missing any item. RESULTS: No statistical significant difference in suicidal ideation (measure by BDI item 9 responses) was found between bipolar and unipolar patients (4.5% vs. 9.1%, respectively). On the group of bipolar patients, suicidal ideation was slightly more frequent among bipolar NOS compared with bipolar I and II (p value 0.094 and 0.086, respectively), interestingly we found a statistical significant less common suicidal ideation among bipolar subtype IV (with hyperthymic temperament) compared with bipolar NOS patients (p value 0.048). CONCLUSIONS: Our results indicate that those subjects with hyperthymic temperament displayed less suicidal ideation. This finding supports the hypothesis that this particular affective temperament could be a protective factor against suicide among affective patients. LIMITATION: The original objective of the national study was the cross validation between MDQ and BSDS in patients with affective disorders in our country. This report arises from a secondary analysis of the original data.
Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno Ciclotímico/diagnóstico , Transtorno Ciclotímico/psicologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Ideação Suicida , Temperamento , Adulto , Transtorno Bipolar/classificação , Transtorno Ciclotímico/classificação , Transtorno Depressivo Maior/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inventário de Personalidade/estatística & dados numéricos , PsicometriaRESUMO
OBJECTIVE: To examine differences in temperament profiles between patients with recurrent unipolar and bipolar depression. METHOD: Depressed individuals with recurrent major depressive disorder (MDD) (n = 94) and those with bipolar (n = 59) disorders (about equally divided between types I and II) were recruited by newspaper advertisement, radio and television announcements, flyers and newsletters, and word of mouth. All patients were interviewed using the Structured Clinical Interview for DSM III-R (SCID) and had the severity of their depressive episode assessed by means of the 17-item Hamilton Rating Scale for Depression. All patients filled out the TEMPS-A, a validated instrument. RESULTS: Temperament differences between bipolar and MDD patients were examined using MANCOVA. Overall significant effect of the fixed factor (bipolar vs. unipolar) was noted for the temperament scores [Hotelling's F((5,142)) = 2.47, p < 0.05]. Overall effects were found for age [F((5,142)) = 2.40, p < 0.05], but not for gender and severity of depression [F((5,142)) = 1.65, p = 0.15 and F((5,142)) = 0.66, p = 0.66, respectively]. Dependent variables included the five subscales of the TEMPS-A, but only the cyclothymic temperament scores showed significant between-group differences. LIMITATION: Small bipolar subsample cell sizes did not permit to test the specificity of the findings for bipolar II vs. bipolar I patients. CONCLUSION: The finding that the clyclothymic subscale is significantly elevated in the bipolar vs. the unipolar depressive group supports the theoretical assumptions upon which the scale is based, and suggests that it might become a useful tool for clinical and research purposes.