Discuss Bipolar
Blog to discuss being Bipolar
Study results show that bipolar disorder (BD) I patients with manic/hypomanic polarity (MP) and depressive polarity (DP) show similar temperaments but are different from patients with unipolar major depression (UP), thus supporting the “predominant polarity” concept for BD.
It has been reported that 45??”70% of all BD patients fulfill criteria for a certain predominant polarity, meaning that at least two-thirds of episodes are restricted to a single pole of the illness.
“This concept has been proven to have diagnostic and therapeutic implications, but little is known on the underlying psychopathology and temperaments,” write Eduard Vieta (University of Barcelona, Spain) and colleagues in the Journal of Affective Disorders.
The researchers therefore analyzed 124 BD I patients, and found that 69 (55.7%) presented predominant polarity criteria, with 68% meeting the criteria for MP and 32% for DP. In addition, 19 patients with UP were included in the assessment of temperament using the Temperament Evaluation of the Memphis, Pisa, Paris, and Sand Diego Autoquestionnaire (TEMPS-A).
Mixed index episodes and suicidal ideation were significantly more frequent in DP compared with MP BD patients, at 77.0% versus 17.0% and 81.8% versus 34.0%, respectively. Furthermore, DP patients had significantly more lifetime mixed episodes than MP patients, at 2.80 versus 1.36.
BD patients with MP and DP had an earlier onset but a shorter duration of depression compared with UP patients. No significant difference was seen in the number of depressive episodes between the DP and UP groups.
When Vieta and team looked at temperamental features among the groups, the distribution of mean scores on the TEMPS-A was able to differentiate bipolar from unipolar patients, as MP and DP patients scored higher on the Hyperthymic and Cyclothymic subscales but lower on the Depressive temperament scale compared with UP patients.
Furthermore, high anxious temperament traits were present in both DP and UP groups, “suggesting that this temperament could represent a link within depressive symptomatology,” according to the authors.
They suggest that “underlying temperament may separate bipolar from unipolar patients, suggesting that data on temperament could be used reliably as a bipolar screening tool in a depressive episode.”
However, the team cautions that the results must be replicated with inclusion of a BD II subgroup before any definitive conclusions may be drawn.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009
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