The relationship between insight and affective temperament in bipolar disorder: an exploratory study

Abstract

Introduction In recent years, the association between temperament and clinical characteristics of mood disorders has been studied. Most bipolar patients show deficits in their awareness of signs and symptoms. The relationship between affective temperament and insight in bipolar patients has not been carried out in the literature so far. Objective To evaluate the relationship between affective temperament and insight in bipolar disorder. Method A group of 65 bipolar patients were followed during a year. Patients underwent a clinical assessment and were diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Insight was evaluated through the Insight Scale for Affective Disorders (ISAD), and affective temperament, through the TEMPS-Rio de Janeiro. The relationship between affective temperament and insight was explored with Spearman rho correlations between scores on each item of the ISAD and on the TEMPS-Rio de Janeiro subscales. Results In euthymic phases, bipolars with depressive temperament were associated with a higher level of insight about the consequences of the disorder; when in mania, patients showed better insight about having an affective disorder, presenting psychomotor alterations, and suffering from guilt or grandiosity. Similarly, bipolar patients with higher scores of anxious temperament, when in mania, had better insight on alterations in attention. Bipolar patients with higher scores of hyperthymic temperament, when in mania, showed the worst insight about thought disorder. Conclusion In addition to being determined by the phase of the disease and several varying symptoms, the level of insight in bipolar patients is also influenced by affective temperament.

A network structure of manic symptoms

“…Blue connections represent positive edges, and red connections represent negative edges. The pie chart surrounding each node represents node predictability may be the sign of a rising mood; this finding is supported by recent literature (Silva et al, 2018).…”

“…Elevated mood is connected with an increased motor activity and insight; although this is not very informative during severe manic episode which is the case at t 0 (because an elevated mood is the core feature of mania), it informs the clinician that when the patient is stable ( t 2 ) a loss of insight (if not present before) or an increased energy may be the sign of a rising mood; this finding is supported by recent literature (Silva et al., 2018).…”

Transtorno afetivo bipolar em paciente gestante com trágico desfecho fetal: relato de caso

“…Tal transtorno anteriormente denominado como maníacodepressivo, por possuir particularidades do grupo das esquizofrenias e da depressão, é um transtorno mental caracterizado por períodos de bom humor e irritação ou depressão, podendo trazer prejuízos para as relações afetivas. O TAB é silencioso, causa mudanças repentinas de comportamento com apresentação de episódios de mania e hipomania 1 .…”