The differences in temperament–character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I and II

Abstract

BackgroundThe primary aim of this study was to compare the differences in temperament–character traits, suicide attempts, impulsivity, and functionality levels of patients with bipolar disorder I (BD-I) and bipolar disorder II (BD-II).MethodsFifty-two BD-I patients and 49 BD-II patients admitted to Erenköy Mental and Neurological Disease Training and Research Hospital psychiatry clinic and fifty age- and sex-matched healthy control subjects were enrolled in this study. A structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Axis I Disorders, Temperament and Character Inventory, Barrett Impulsiveness Scale-11 (BIS-11), Hamilton Depression Inventory Scale, Young Mania Rating Scale, and Bipolar Disorder Functioning Questionnaire (BDFQ) were administered to patients and to control group.ResultsNo statistically significant difference in sociodemographic features existed between the patient and control groups (P>0.05). Thirty-eight subjects (37.62%) in the patient group had a suicide attempt. Twenty-three of these subjects (60.52%) had BD-I, and 15 of these subjects (39.47%) had BD-II. Suicide attempt rates in BD-I and II patients were 60.52% and 39.47%, respectively (P<0.05). Comparison of BD-I and II patients with healthy control subjects revealed that cooperativeness (C), self-directedness (Sdi), and self-transcendence (ST) scores were lower and novelty seeking (NS1 and NS2), harm avoidance (HA4), and reward dependence (RD2) subscale scores were higher in patients with BD-I. When BD-I patients were compared with BD-II patients, BIS-11 (attention) scores were higher in patients with BD-II and BIS-11 (motor and nonplanning impulsivity) scores were higher in patients with BD-I. According to BDFQ, relations with friends, participation in social activities, daily activities and hobbies, and occupation subscale scores were lower and taking initiative subscale scores were higher in patients with BD-I. Social withdrawal subscale scores were higher in patients with BD-II.ConclusionIn our study, NS, HA, and RD scores that may be found high in suicide attempters and Sdi scores that may be found low in suicide attempters were as follows: NS1, NS2, HA4, and RD2 subscale scores were high and Sdi scores were low in patients with BD-I, suggesting a higher rate of suicide attempts in this group of patients. In addition, C and Sdi scores that indicate a predisposition to personality disorder were significantly lower in patients with BD-I than patients with BD-II and healthy controls, suggesting a higher rate of personality disorder comorbidity in patients with BD-I. Higher impulsivity and suicidality rates and poorer functionality in patients with BD-I also suggest that patients with BD-I may be more impulsive and more prone to suicide and have poorer functionality in some areas.

The Temperament and Character Traits in Patients With Major Depressive Disorder and Bipolar Affective Disorder With and Without Suicide Attempt

“…It has been proposed that this is probably related to sample size, study methodology, patient selection and severity of suicidal attempt (Perroud et al 2013, Kampman et al 2012, see Kampman et al 2011). Our findings in the group of suicide attempters with severe depressive episode in bipolar disorder (BD-sDE) confirmed the results from several previous studies on higher scores of particular temperament dimensions: NS and HA, and lower scores on character dimensions SD, PS, CO (see Izci et al 2016, Engstrom et al 2003. Interestingly, in the previously mentioned group of patients and also in the group of suicide attempters in general, we found lower scores on SD and CO character dimensions.…”

“…Patients with BD have a suicide rate 30 times higher than the general population and 25-50% of these patients will attempt suicide once in their lifetime (Marangell et al 2006). Fifteen percent of those who attempted suicide eventually make complete suicide (Izci et al 2016). Although MDD has an overall negative health impact and is associated with morbidity which is hard to determine, its lethality becomes measurable through a perspective of completed suicide (Harwitz & Ravizza 2000).…”

The dual-system theory of bipolar spectrum disorders: A meta-analysis

“…This was, essentially, a combination of the relationships that reinforcement sensitivity has with self-report measures of risk for (hypo)mania and depression. Effect sizes were not moderated by diagnosis (e.g., BP-I vs. BP-II ;see Izci et al, 2016;cf. Lu et al, 2012).…”

Depressive symptoms as a mediator between impulsiveness and suicidal ideation among Chinese medical college students

“…For suicide prevention, it is critical to detect, manage, and intervene in both suicide attempts and ideation. There are many studies investigating risk factors for suicide attempts (3)(4)(5)(6)(7)(8)(9) but fewer investigations on suicidal ideation. Someone who attempts suicide has executed suicide preparation at least once.…”