Temperament in bipolar illness: impact on prognosis

Objective: The present study was designed to investigate the relations betw een temperament and outcome in bipolar illness. Methods: Seventy-two patien ts presenting with bipolar type I disorder were recruited from consecutive admissions and evaluated when euthymic. The criteria developed by Akiskal a nd Mallya (Criteria for the 'soft' bipolar spectrum: treatment implications . Psychopharmacol. Bull. 1987;23:68-73) were used to assess both depressive (DT) and hyperthymic temperaments (HT) in a dimensional approach. Results: Multiple regression analysis showed that a higher DT score or a lower HT s core were significantly associated with a greater number of episodes. Furth ermore, a higher DT score was strongly associated with a higher percentage of major depressive episodes. Conversely, a higher HT score was associated with a trend to manic rather than depressive episodes. Suicide attempts app eared more frequent in the history of patients presenting with higher DT sc ores. Conclusions: Our findings strengthen the hypothesis that temperament is one of the main variables accounting for some features in the clinical e volution of bipolar disorder such as polarity of episodes. Furthermore, the se findings are consistent with the hypothesis of a trait-state continuum b etween personality and affective episodes. (C) 1999 Elsevier Science B.V. A ll rights reserved.