Citation

Touati I, Mechri A, Gassab L, Bacha M, Gaha L. Ann. Med. Psychol. (Paris) 2009; 167(10): 787-791.

Copyright

(Copyright © 2009, Societe Medico-Psychologique, Publisher Elsevier Publishing)

DOI

10.1016/j.amp.2009.03.006

PMID

unavailable

Abstract

INTRODUCTION: The current categorical split of mood disorders into bipolar disorders and depressive disorders has recently been questioned after the widening of the bipolar spectrum. Recent studies have suggested that clinicians may under-diagnose bipolarity in a substantial proportion of depressed patients, and have proposed the existence of a "pseudo-unipolar" depression. On the other hand, many studies were made to identify factors correlated to bipolarity in depressive disorders. They have shown that the main clinical factors correlated to bipolarity are: pharmacological hypomania, puerperal depression, early age of onset, psychotic features, hypersomnia and psychomotor inhibition. In this context, it should be interesting to study temperaments as predictive factors of bipolarity in depression and to explore their correlation with those clinical predictors.

OBJECTIVES: The aims of this study were to assess affective temperaments in patients with recurrent depressive disorders, and to explore the correlations between these temperaments and clinical features of depressive disorders.

METHODS: The study was a cross-sectional one bearing on 91 recurrent depressive patients (40 men and 51 women, mean age: 46.8 ± 10.1 years), who were interviewed using the DSM-IV Structured Clinical Interview during the partial or total recovery period. Data was collected using available medical records. The evaluation of affective temperaments consisted in filling in the Akiskal and Mallya semi-structured questionnaire.

RESULTS: The depressive temperament obtained the higher mean score (12.3 ± 4.74), followed by the hyperthymic temperament (7.8 ± 4.5), the cyclothymic temperament (5.9 ± 5.8) and the irritable temperament (4.9 ± 3.3). A significant association was found between the onset of the first depressive episode during the postpartum period and the cyclothymic temperament score (7.4 ± 6.9 versus 3.3 ± 3.6, p = 0.04). The psychotic features in the last depressive episode were significantly associated with the hyperthymic (p = 0,001), the cyclothymic (p < 10-3) and the irritable temperament scores (p < 10-3). A significant link was found between suicide attempts during the last depressive episode and the cyclothymic temperament on the one hand (p < 10-3) and the irritable temperament on the other hand (p = 0.01).

CONCLUSIONS: The recurrent depressive disorders with hyperthymic, cyclothymic and the irritable temperaments seem to have clinical features similar to those of bipolar disorders. These results point to the importance of evaluating these temperaments in depressed patients, considering the risk of polarity change and of misdiagnoses of unipolar depression. © 2009 Elsevier Masson SAS. All rights reserved.

Language: fr

Keywords

adult; human; female; male; bipolar disorder; depression; affect; psychosis; scoring system; suicide attempt; major depression; Affective temperaments; Unipolar depression; mood disorder; article; major clinical study; clinical feature; recurrent disease; cross-sectional study; puerperal depression; irritability; diagnostic error; onset age; anamnesis; hypomania; psychomotor retardation; correlation analysis; convalescence; temperament; hypersomnia; puerperium; Structured Clinical Interview for DSM Disorders; medical record review; semi structured interview; cyclothymia; Bipolar spectrum; Prebipolar temperaments; Recurrent depressive disorders