Bipolar II disorder and its premorbid personality

This study psychopathologically analyzes and compares the premorbid persona lities associated with bipolar II disorder and unipolar depression. Using C loninger's tridimensional personality theory, we evaluated 14 inpatients wi th bipolar II disorder and 14 inpatients with unipolar depression. The resu lts indicate that the premorbid personality associated with bipolar II diso rder is characterized as The reward-dependent, passive-avoidant/dependent t endency of personality' or 'the dependent tendency of personality'. We also clarified that atypical symptoms of bipolar II disorder, such as the hypom anic state and the mixed state, were induced by the mingling of this tenden cy with the melancholic personality type (Tellenbach) or the cycloid person ality type (Kretschmer), both of which are based on syntony (Minkowski), ca tegorized by the use of an obsessional defense mechanism to maintain stable social relations. When an insufficiency in the obsessional defense weakens the syntony, the dependent tendency engenders the symptoms stated above. A lthough few serious problems associated with the dependent tendency may hav e occurred previously, it may have resulted in conflicts with others after onset of the bipolar II disorder. Therefore, psychotherapy for these confli cts is necessary along with the administration of mood stabilizers. Copyrig ht (C) 2000 S.Karger AG, Basel.