Bipolar II with and without cyclothymic temperament: “dark” and “sunny” expressions of soft bipolarity

Akiskal, Hagop S.; Hantouche, Elie G.; Allilaire, J. F.

doi:10.1016/s0165-0327(02)00320-8

Cited by 196 publications

(99 citation statements)

References 22 publications

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“…Reversely, as mentioned before, cyclothymic BD-II patients are reported to manifest more atypical features 119 .…”

Section: Clinical Issuessupporting

confidence: 50%

“…Furthermore, cyclothymic BP-II patients displayed a significantly higher score on irritable-riskitems of hypomania compared to "classic" driven-euphoric items 119 . Cyclothymic patients might more frequently be females and manifest a higher number of depressive and hypomanic episodes and suicide attempts, more axis I lifetime co-morbidities (usually panic disorder/agoraphobia and social anxiety disorder), they meet more borderline personality disorder criteria and have higher rates of first-degree family history for both mood and anxiety disorders when compared to hyperthymic patients who in turn might have more frequent manic episodes and hospitalizations and more antisocial personality disorder features 120 .…”

Section: Clinical Issuesmentioning

confidence: 88%

“…These traits often coexist with the mood-labile cyclothymic type, representing a darker, "borderline" side of this temperament 119,121,122 . The type BP-II ½ (patients with cyclothymic temperament developing depressive episodes) manifests early onset, complex temperament structure, and high mood instability, rapid switching, irritable ("dark") hypomania and suicidality and seems to be the most prevalent and severe expression of the bipolar spectrum, accounting for 33% of all depressions 123 .…”

Section: Clinical Issuesmentioning

confidence: 99%

See 2 more Smart Citations

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

Fountoulakis

Gonda

Koufaki

et al. 2016

Harvard Review of Psychiatry

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Bipolar disorder constitutes a challenge for clinicians in everyday clinical practice. Our knowledge concerning this clinical entity is incomplete and contemporary classification systems are unable to reflect the complexity of this disorder.. The concept of temperament which for the first time was described during antiquity constitutes a reasonable vehicle to synthesize our knowledge on how the human body works and what determines human behavior. Although it originally included philosophical and sociocultural approaches, today the biomedical model is dominant. It is possible that specific temperaments might constitute vulnerability factors, determine the clinical picture or constitute illness course modifiers and even act as a bridge between genes and clinical manifestations, thus giving birth to the concept of the bipolar spectrum with major implications for all aspects of mental health research and providing of care. More specifically it has been reported that the hyperthymic and the depressive temperaments are related to the more 'classic' bipolar disorder, while cyclothymic, anxious and irritable temperaments are related to more complex manifestations and might predict poor response to treatment, violent or suicidal behavior and high comorbidity. It seems reasonable to assume that the incorporating of the concept of temperament and the bipolar spectrum in the standard training of psychiatric residents might result in an improvement of everyday clinical practice.3

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“…Reversely, as mentioned before, cyclothymic BD-II patients are reported to manifest more atypical features 119 .…”

Section: Clinical Issuessupporting

confidence: 50%

Section: Clinical Issuesmentioning

confidence: 88%

Section: Clinical Issuesmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

Fountoulakis

Gonda

Koufaki

et al. 2016

Harvard Review of Psychiatry

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“…The MDQ question on impairment may also be a cause of misdiagnosis [17]. However, the validity of its questions on hypomanic symptoms is supported by our factor analysis which showed a two-factor structure of manic/hypomanic syndromes similar to that found in clinical samples [18, 19]. …”

Section: Discussionmentioning

confidence: 54%

Assessing the Community Prevalence of Bipolar Spectrum Symptoms by the Mood Disorder Questionnaire

Mangelli

Benazzi²,

Fava³

2005

Psychother Psychosom

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Background: The goal of this study was to assess the frequency and spectrum of symptoms related to bipolar disorders in a community sample by means of a self-rating questionnaire. Method: The Mood Disorder Questionnaire, a self-rating scale which evaluates DSM-IV manic/hypomanic symptoms, was administered to a community sample of 1,034 individuals recruited through advertisements. Symptom interrelationships were studied by factor analysis. Results: 275 individuals (26.6%) reported moderate or severe impairment due to the symptoms. Manic/hypomanic symptoms were present in a high proportion of individuals. Factor analysis found a two-factor structure of bipolar spectrum symptoms (an elevated mood overactivity factor, and an irritable behavior factor). Conclusion: The findings of this study highlight the need of complementing clinical investigations on the bipolar spectrum with community studies. Subclinical manic-hypomanic symptoms may be present also in allegedly unipolar patients and may have implications on the course of illness.

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“…Classically, trait impulsivity in bipolar disorder has been included among temperamental features Akiskal, Hantouche et al 2003;. Affective temperament has been conceptualized as biological disposition, corresponding to a constitutional substrate expressed through a series of signs and features, usually manifested by a certain stability since the childhood, of affectivity and mood, attitudes toward the environment, sensitivity to external stimuli and characteristic modes of reaction (Akiskal 1996).…”

Section: The Role Of Impulsivity In Mood Disordersmentioning

confidence: 99%