Predominant polarity and temperament in bipolar and unipolar affective disorders

Mazzarini, Lorenzo; Pacchiarotti, Isabella; Colom, Francesc; Sani, Gabriele; Kotzalidis, Georgios D.; Rosa, Adriane Ribeiro; Sanna, Livia; Rossi, Pietro De; Girardi, Nicoletta; Bonnín, C.M.; Sanchez-Moreno, José; Vázquez, Gustavo; Gastó, Cristòbal; Tatarelli, Roberto; Vieta, Eduard

doi:10.1016/j.jad.2009.03.016

Cited by 70 publications

(50 citation statements)

References 35 publications

(52 reference statements)

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“…Main differences, probably due to a larger study sample, involved gender, history of psychotic symptoms, substance use preceding first episode and seasonal pattern. Other findings were consistent, as expected with data from our group (35,39), but also from independent samples from other areas, countries, and continents (15,38,40,41). An issue raised during this research is whether it was the PP to determine the different prescribing pattern.…”

Section: Discussionsupporting

confidence: 90%

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Popović

Torrent

Goikolea

et al. 2013

Acta Psychiatr Scand

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Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study.Objective: Predominant polarity (PP) is an important variable in maintenance treatment of bipolar disorder (BD). This study aimed at determining the role of polarity index (PI), a metric indicating antimanic versus antidepressive prophylactic potential of drugs, in clinical decision-making. Method: Two hundred and fifty-seven of 604 (43%) of patients with BD-I or II fulfilled criteria for manic (MPP) or depressive PP (DPP). The PI, representing the ratio of number needed to treat (NNT) for depression prevention to NNT for mania prevention, was calculated for patients' current treatment. MPP and DPP groups were compared regarding sociodemographic, clinical and therapeutic characteristics. Results: One hundred and forty-three patients (55.6%) fulfilled criteria for DPP and 114 (44.4%) for MPP. Total PI, Antipsychotics' PI, and mood stabilizers PI were higher, indicating a stronger antimanic action, in MPP. MPP presented higher prevalence of BD-I, male gender, younger age, age at onset and at first hospitalization, more hospitalizations, primary substance misuse, and psychotic symptoms. DP correlated with BD-II, depressive onset, primary life events, melancholia, and suicide attempts. Conclusion:The results confirm the usefulness of the PI. In this large sample, clinical differences among these groups justify differential treatment approach. The PI appears to be a useful operationalization of what clinicians do for maintenance therapy in BD.

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Section: Discussionsupporting

confidence: 90%

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Popović

Torrent

Goikolea

et al. 2013

Acta Psychiatr Scand

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“…In our sample hyperthymia predominated, while others reported more cyclothymic [52,53] or dysthymic [21] temperaments in MxD. Since hyperthymic temperament is more common in BD than MDD [54,55], this finding suggests that MxD may share much clinical and biological background with bipolar disorder.…”

Section: Discussionmentioning

confidence: 42%

Mixed Depression: Clinical Features and Predictors of Its Onset Associated with Antidepressant Use

Sani¹,

Napoletano

Vöhringer

et al. 2014

Psychother Psychosom

Self Cite

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Background: Mixed depression (MxD) is narrowly defined in the DSM-IV and somewhat broader in the DSM-5, although both exclude psychomotor agitation as a diagnostic criterion. This article proposes a clinical description for defining MxD, which emphasizes psychomotor excitation. Methods: Two hundred and nineteen consecutive outpatients were diagnosed with an MxD episode using criteria proposed by Koukopoulos et al. [Acta Psychiatr Scand 2007;115(suppl 433):50-57]; we here report their clinical features and antidepressant-related effects. Results: The most frequent MxD symptoms were: psychic agitation or inner tension (97%), absence of retardation (82%), dramatic description of suffering or weeping spells (53%), talkativeness (49%), and racing or crowded thoughts (48%). MxD was associated with antidepressants in 50.7% of patients, with similar frequency for tricyclic antidepressants (45%) versus selective serotonin reuptake inhibitors (38.5%). Positive predictors of antidepressant-associated MxD were bipolar disorder type II diagnosis, higher index depression severity, and higher age at index episode. Antipsychotic or no treatment was protective against antidepressant-associated MxD. Conclusions: MxD, defined as depression with excitatory symptoms, can be clinically identified, is common, occurs in both unipolar depression and bipolar disorder, and is frequently associated with antidepressant use. If replicated, this view of MxD could be considered a valid alternative to the DSM-5 criteria for depression with mixed features.

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“…The first one (Henry et al, 1999) found that the percentage of manic episodes was positively correlated to hyperthymic temperament scores, whereas the total number of depressive episodes was linked to depressive temperament scores, but negatively correlated to hyperthymic temperament measures. The second study (Mazzarini et al, 2009) did not find evidence for differences in affective temperaments as a function of predominant polarity. However, it is likely that this study had not the power to detect such differences due to the small number of patients included in some of the predominant polarity subgroups.…”

Section: Introductionmentioning

confidence: 84%

“…Different factors have been associated with predominant mania and predominant depression (Carvalho et al, 2014), but only two studies reported on affective temperaments as a function of predominant polarity (Henry et al, 1999;Mazzarini et al, 2009). However, these studies yielded controversial findings.…”

Section: Introductionmentioning

confidence: 99%

Predominant polarity in bipolar disorders: Further evidence for the role of affective temperaments

Azorin

Adida

Belzeaux

2015

Journal of Affective Disorders

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Predominant polarity and temperament in bipolar and unipolar affective disorders

Cited by 70 publications

References 35 publications

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Clinical implications of predominant polarity and the polarity index in bipolar disorder: a naturalistic study

Mixed Depression: Clinical Features and Predictors of Its Onset Associated with Antidepressant Use

Predominant polarity in bipolar disorders: Further evidence for the role of affective temperaments

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