Psychopathology, Temperament, and Past Course in Primary Major Depressions

Abstract

In reviewing recent findings on affective conditions in the interface of unipolar and bipolar disorders, we find evidence favoring a partial return to Kraepelin’s broad concept of manic-depressive illness, which included many recurrent depressives and temperamental variants. This review addresses methodologic, clinical, and familial considerations in the definition and characterization of a proposed spectrum of bipolar disorders which subsumes episodic and chronic forms. Episodic bipolar disorders are subclassified into bipolar schizoaffective, and bipolar I and II, and bipolar III or pseudo-unipolar forms. Chronic bipolar disorders could be either intermittent or persistent, and are subclassified into chronic mania, protracted mixed states, and rapid-cycling forms, as well as the classical temperaments (cyclothymic, hyperthymic, irritable and dysthymic).

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

“…Considering the temperament issue in a wider sense, temperaments could constitute all the above in different proportions, but even in the same patient [158][159][160][161][162][163][164][165][166][167] . Affective temperaments seem to relate also to mood disorders in the family history, thus constituting an endophenotype bridge between genes and mood disorders 72,140,144,147,148 .…”

Significance of borderline personality-spectrum symptoms among adolescents with bipolar disorder

“…BPD is conceptualized as a chronic and persistent personality disorder whereas BP is conceptualized as an episodic mood disorder (American Psychiatric Association, 2013). However, there is increasing evidence that symptoms of BPD wax and wane and that there are often substantial inter-episode symptoms in BP (Akiskal et al, 1989;Morriss, 2002;Zanarini et al, 2005). Some studies argue that BPD is best reframed as part of the BP spectrum due to symptomatic and familial genetic overlap between these diagnostic phenotypes.…”

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“…Εάν αναλογιστούμε το θέμα της ιδιο-συγκρασίας με την ευρύτερη έννοια, οι ιδιοσυγκρασίες μπορεί να αποτελούν όλα τα παραπάνω σε διαφορετι-κές αναλογίες, ακόμη και στον ίδιο ασθενή. [89][90][91][92][93][94][95][96][97][98] Οι συ-ναισθηματικές ιδιοσυγκρασίες φαίνεται να σχετίζονται επίσης με το οικογενειακό ιστορικό συναισθηματικών διαταραχών, σχηματίζοντας έτσι έναν ενδοφαινότυπο που γεφυρώνει τα γονίδια με τις συναισθηματικές δι-αταραχές. 41,74,78,81,82 Κάτω από αυτό το πρίσμα θεώρη-σης των συναισθηματικών διαταραχών, γεννιέται η έν-νοια του διπολικού φάσματος με ισχυρές ενδείξεις για όλες τις πτυχές της έρευνας στην ψυχική υγεία και την παροχή φροντίδας.…”