RELATIONSHIP BETWEEN HYPOMANIA AND PERSONALITY-DISORDERS BEFORE AND AFTER SUCCESSFUL TREATMENT

Objective: To examine the effect of hypomanic states on maladaptive pe rsonality traits and personality disorders, the authors evaluated pers onality traits and disorders of patients during an episode of hypomani a and after successful somatic treatment Method: The authors used the Structured Interview, for DSM-III Personality Disorders to study 66 ou tpatients who had a lifetime diagnosis of bipolar disorder and who met the minimum Research Diagnostic Criteria for hypomania. All patients had a knowledgeable informant separately undergo the Structured Interv iew for DSM-III Personality Disorders during the patient's hypomanic s tate. Outpatients who successfully recovered from the hypomanic episod e (N=47) and their informants were readministered the interview 4-8 we eks after the initial assessment. Results: During the hypomanic state, informants generally reported higher levels of maladaptive personalit y traits among patients than patients themselves. For the patients who recovered successfully from the hypomanic episode, a reduction in all maladaptive personality traits except schizoid and dependent traits w as reported by both patients and their informants; however, the decrea se reported by patients generally was much greater than that reported by informants. In addition, schizoid traits actually increased after s uccessful treatment according to patient reports but were unchanged ac cording to informant reports. Conclusions: Hypomania may be associated with an exacerbation of maladaptive personality traits, which may be attenuated after successful treatment. Evert with the attainment of eu thymic mood, however, about 50% of the cohort had at least one persona lity disorder, which suggests that a high degree of comorbidity may ex ist between bipolar disorders and maladaptive personality traits or pe rsonality disorders.