Effect of affective temperament on illness characteristics of subjects with bipolar disorder and major depressive disorder

Simonetti, Alessio; Luciano, Mario; Sampogna, Gaia; Rocca, Bianca Della; Mancuso, Emiliana; Fazio, Pasquale De; Nicola, Marco Di; Lorenzo, Giorgio Di; Pepe, Maria; Sambataro, Fabio; Signorelli, Maria Salvina; Koukopoulos, Alexia E.; Chiaie, Roberto Delle; Fiorillo, Andrea; Sani, Gabriele

doi:10.1016/j.jad.2023.04.130

Cited by 3 publications

(2 citation statements)

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“…In addition, we did not assess affective temperaments despite their potential influence on mood disorder course and severity. 34 Similarly, we did not report information on lifetime history of suicidal attempts, due to the high risk of recall bias. Finally, our study assumed just a categorical perspective for AD as well as for covariates, such as substance use and personality disorders, since the relatively small sample size did not allow us to consider their severity.…”

Section: Discussionmentioning

confidence: 99%

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Anxious distress in people with major depressive episodes: a cross-sectional analysis of clinical correlates

Bartoli,

Bachi,

Callovini

et al. 2023

CNS Spectr.

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Objective Most people with major depressive episodes meet the criteria for the anxious distress (AD) specifier defined by DSM-5 as the presence of symptoms such as feelings of tension, restlessness, difficulty concentrating, and fear that something awful may happen. This cross-sectional study was aimed at identifying clinical correlates of AD in people with unipolar or bipolar depression. Methods Inpatients with a current major depressive episode were included. Data on socio-demographic and clinical variables were collected. The SCID-5 was used to diagnose depressive episodes and relevant specifiers. The Montgomery–Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS) were used to assess the severity of depressive and manic (mixed) symptoms, respectively. Multiple logistic regression analyses were carried out to identify clinical correlates of AD. Results We included 206 people (mean age: 48.4 ± 18.6 yrs.; males: 38.8%) admitted for a major depressive episode (155 with major depressive disorder and 51 with bipolar disorder). Around two-thirds of the sample (N = 137; 66.5%) had AD. Multiple logistic regression models showed that AD was associated with mixed features, higher YMRS scores, psychotic features, and a diagnosis of major depressive disorder (p < 0.05). Conclusion Despite some limitations, including the cross-sectional design and the inpatient setting, our study shows that AD is likely to be associated with mixed and psychotic features, as well as with unipolar depression. The identification of these clinical domains may help clinicians to better contextualize AD in the context of major depressive episodes.

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Section: Discussionmentioning

confidence: 99%

“…These subjects may not be representative of the overall clinical population with depression. In addition, we did not assess affective temperaments despite their potential influence on mood disorder course and severity 34 . Similarly, we did not report information on lifetime history of suicidal attempts, due to the high risk of recall bias.…”

Section: Discussionmentioning

confidence: 99%

Anxious distress in people with major depressive episodes: a cross-sectional analysis of clinical correlates

Bartoli,

Bachi,

Callovini

et al. 2023

CNS Spectr.

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Homocysteine, hopelessness, rumination, affective temperaments, and clinical course in patients with bipolar disorder-1

Aydın,

Özcan,

Yılmaz

et al. 2024

Nordic Journal of Psychiatry

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Combining predominant polarity and affective spectrum concepts in bipolar disorder: towards a novel theoretical and clinical perspective

Bartoli,

Malhi,

Carrà

2024

Int J Bipolar Disord

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This is an overview of recent advances on predominant polarity conceptualization in bipolar disorder (BD). Current evidence on its operationalized definitions, possible contextualization within the affective spectrum, along with its epidemiological impact, and treatment implications, are summarized. Predominant polarity identifies three subgroups of patients with BD according to their mood recurrencies: (i) those with depressive or (ii) manic predominance as well as (iii) patients without any preponderance (‘nuclear’ type). A predominant polarity can be identified in approximately half of patients, with similar rates for depressive and manic predominance. Different factors may influence the predominant polarity, including affective temperaments. More generally, affective disorders should be considered as existing on a spectrum ranging from depressive to manic features, also accounting for disorders with ‘ultrapredominant’ polarity, i.e., unipolar depression and mania. While mixed findings emerge on its utility in clinical practice, it is likely that the construct of predominant polarity, in place of conventional differentiation between BD-I and BD-II, may be useful to clarify the natural history of the disorder and select the most appropriate interventions. The conceptualization of predominant polarity seems to reconcile previous theoretical views of both BD and affective spectrum into a novel perspective. It may provide useful information to clinicians for the early identification of possible trajectories of BD and thus guide them when selecting interventions for maintenance treatment. However, further research is needed to clarify the specific role of predominant polarity as a key determinant of BD course, outcome, and treatment response.

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Effect of affective temperament on illness characteristics of subjects with bipolar disorder and major depressive disorder

Cited by 3 publications

References 85 publications

Anxious distress in people with major depressive episodes: a cross-sectional analysis of clinical correlates

Anxious distress in people with major depressive episodes: a cross-sectional analysis of clinical correlates

Homocysteine, hopelessness, rumination, affective temperaments, and clinical course in patients with bipolar disorder-1

Combining predominant polarity and affective spectrum concepts in bipolar disorder: towards a novel theoretical and clinical perspective

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