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Differences in temperament and character dimensions in patients with bipolar I or II or major depressive disorder and general population subjects

Published online by Cambridge University Press:  12 January 2011

P. Jylhä
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland
O. Mantere
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland
T. Melartin
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland
K. Suominen
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland
M. Vuorilehto
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland
P. Arvilommi
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland
I. Holma
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland
M. Holma
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland
S. Leppämäki
Affiliation:
Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
H. Valtonen
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland Department of Psychiatry, Jorvi Hospital, Helsinki University Central Hospital, Espoo, Finland
H. Rytsälä
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland
E. Isometsä*
Affiliation:
Department of Mental Health and Substance Use, National Institute of Health and Welfare, Helsinki, Finland Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
*
*Address for correspondence: Professor E. T. Isometsä, M.D., Ph.D., Department of Psychiatry, Institute of Clinical Medicine, University of Helsinki, PO Box 22, FI-00014 Helsinki, Finland. (Email: [email protected])

Background

Whether temperament and character differ between bipolar disorder (BD) and major depressive disorder (MDD) patients and general population subjects, or between BD I and BD II patients, remains unclear.

Method

BD patients (n=191) from the Jorvi Bipolar Study and MDD patients (n=266) from the Vantaa Depression Study (VDS) and the Vantaa Primary Care Depression Study were interviewed at baseline, at 6 and 18 months, and in the VDS at 5 years. A general population comparison group (n=264) was surveyed by mail. BD patients' scores on the Temperament and Character Inventory-Revised were compared at an index interview, when levels of depression and mania were lowest, with scores of MDD patients and controls. BD I (n=99) and BD II (n=92) patients were compared.

Results

Compared with controls, both BD and MDD patients had higher harm avoidance [odds ratio (OR) 1.027, p<0.001 and OR 1.047, p<0.001, respectively] and lower persistence (OR 0.983, p=0.006 and OR 0.968, p<0.001, respectively) scores. Moreover, BD patients had lower self-directedness (OR 0.979, p=0.003), MDD patients lower reward dependence (OR 0.976, p=0.002) and self-transcendence (OR 0.966, p<0.001) scores. BD patients scored lower in harm avoidance (OR 0.980, p=0.002) and higher in novelty seeking (OR 1.027, p<0.001) and self-transcendence (OR 1.028, p<0.001) than MDD patients. No differences existed between BD I and II patients.

Conclusions

The patterns of temperament and character dimensions differed less between BD and MDD patients, than patients from their controls. The most pronounced difference was higher novelty seeking in BD than MDD patients. The dimensions investigated are unlikely to differ between BD I and BD II patients.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

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References

Agosti, V, McGrath, PJ (2002). Comparison of the effects of fluoxetine, imipramine and placebo on personality in atypical depression. Journal of Affective Disorders 71, 113120.CrossRefGoogle ScholarPubMed
Beck, AT, Epstein, N, Brown, G, Steer, RA (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893897.CrossRefGoogle ScholarPubMed
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561571.CrossRefGoogle ScholarPubMed
Benazzi, F, Akiskal, H (2001). Delineating bipolar II mixed states in the Ravenna–San Diego collaborative study: the relative prevalence and diagnostic significance of hypomanic features during major depressive episodes. Journal of Affective Disorders 67, 115122.CrossRefGoogle Scholar
Brown, SL, Svrakic, DM, Przybeck, TR, Cloninger, CR (1992). The relationship of personality to mood and anxiety-states – a dimensional approach. Journal of Psychiatric Research 26, 197211.CrossRefGoogle ScholarPubMed
Cloninger, CR (1994). The Temperament and Character Inventory (TCI): a Guide to its Development and Use. Center for Psychobiology of Personality, Washington University: St Louis, MO.Google Scholar
Cloninger, CR, Svrakic, DM, Przybeck, TR (1993). A psychobiological model of temperament and character. Archives of General Psychiatry 50, 975990.CrossRefGoogle ScholarPubMed
Engström, C, Brändström, S, Sigvardsson, S, Cloninger, R, Nylander, PO (2004). Bipolar disorder: I. Temperament and character. Journal of Affective Disorders 82, 131134.CrossRefGoogle ScholarPubMed
Enns, MW, Cox, BJ (1997). Personality dimensions and depression: review and commentary. Canadian Journal of Psychiatry 42, 274284.CrossRefGoogle Scholar
Evans, L, Akiskal, HS, Keck, PE Jr., McElroy, SL, Sadovnick, AD, Remick, RA, Kelsoe, JR (2005). Familiality of temperament in bipolar disorder: support for a genetic spectrum. Journal of Affective Disorders 85, 153168.CrossRefGoogle ScholarPubMed
Farmer, A, Mahmood, A, Redman, K, Harris, T, Sadler, S, McGuffin, P (2003). A sib-pair study of the Temperament and Character Inventory scales in major depression. Archives of General Psychiatry 60, 490496.CrossRefGoogle ScholarPubMed
First, M, Spitzer, RL, Gibbon, M, Williams, JB (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Patient Edition With Psychotic Screen. Biometrics Research, New York State Psychiatric Institute: New York.Google Scholar
Goel, N, Terman, M, Terman, JS (2003). Dimensions of temperament and bright light response in seasonal affective disorder. Psychiatry Research 119, 8997.CrossRefGoogle Scholar
Goodwin, FK, Jamison, KR (2007). Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression (2nd edn). Oxford University Press: New York.Google Scholar
Hamilton, M (1960). A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry 23, 5662.CrossRefGoogle ScholarPubMed
Hansenne, M, Bianchi, J (2009). Emotional intelligence and personality in major depression: trait versus state effects. Psychiatry Research 166, 6368.CrossRefGoogle ScholarPubMed
Hansenne, M, Reggers, J, Pinto, E, Kjiri, K, Ajamier, A, Ansseau, M (1999). Temperament and character inventory (TCI) and depression. Journal of Psychiatric Research 33, 3136.CrossRefGoogle ScholarPubMed
Holma, KM, Holma, IA, Melartin, TK, Rytsälä, HJ, Isometsä, ET (2008). Long-term outcome of major depressive disorder in psychiatric patients is variable. Journal of Clinical Psychiatry 69, 196205.CrossRefGoogle ScholarPubMed
Janowsky, DS, Morter, S, Hong, L, Howe, L (1999). Myers Briggs Type Indicator and Tridimensional Personality Questionnaire differences between bipolar patients and unipolar depressed patients. Bipolar Disorders 1, 98–108.CrossRefGoogle ScholarPubMed
Jylhä, P, Isometsä, E (2006). Temperament, character and symptoms of anxiety and depression in the general population. European Psychiatry 21, 389395.CrossRefGoogle ScholarPubMed
Jylhä, P, Mantere, O, Melartin, T, Suominen, K, Vuorilehto, M, Arvilommi, P, Leppämäki, S, Valtonen, H, Rytsälä, H, Isometsä, E (2010). Differences in neuroticism and extraversion between patients with bipolar I or II and general population subjects or major depressive disorder patients. Journal of Affective Disorders 125, 4252.CrossRefGoogle ScholarPubMed
Kimura, S, Sato, T, Takahashi, T, Narita, T, Hirano, S, Goto, M (2000). Typus melancholicus and the Temperament and Character Inventory personality dimensions in patients with major depression. Psychiatry and Clinical Neurosciences 54, 181189.CrossRefGoogle ScholarPubMed
Kusunoki, K, Sato, T, Taga, C, Yoshida, T, Komori, K, Narita, T, Hirano, S, Iwata, N, Ozaki, N (2000). Low novelty-seeking differentiates obsessive-compulsive disorder from major depression. Acta Psychiatrica Scandinavica 101, 403405.CrossRefGoogle ScholarPubMed
Mantere, O, Suominen, K, Leppämäki, S, Valtonen, H, Arvilommi, P, Isometsä, E (2004). The clinical characteristics of DSM-IV bipolar I and II disorders: baseline findings from the Jorvi Bipolar Study (JoBS). Bipolar Disorders 6, 395405.CrossRefGoogle ScholarPubMed
Mantere, O, Suominen, K, Valtonen, HM, Arvilommi, P, Leppämäki, S, Melartin, T, Isometsä, E (2008). Differences in outcome of DSM-IV bipolar I and II disorders. Bipolar Disorders 10, 413425.CrossRefGoogle ScholarPubMed
Melartin, TK, Rytsälä, HJ, Leskelä, US, Lestelä-Mielonen, PS, Sokero, TP, Isometsä, ET (2002). Current comorbidity of psychiatric disorders among DSM-IV major depressive disorder patients in psychiatric care in the Vantaa Depression Study. Journal of Clinical Psychiatry 63, 126134.CrossRefGoogle ScholarPubMed
Mula, M, Pini, S, Monteleone, P, Iazzetta, P, Preve, M, Tortorella, A, Amato, E, Di Paolo, L, Conversano, C, Rucci, P, Cassano, GB, Maj, M (2008). Different temperament and character dimensions correlate with panic disorder comorbidity in bipolar disorder and unipolar depression. Journal of Anxiety Disorders 22, 14211426.CrossRefGoogle ScholarPubMed
Nery, FG, Hatch, JP, Glahn, DC, Nicoletti, MA, Monkul, ES, Najt, P, Fonseca, M, Bowden, CL, Cloninger, CR, Soares, JC (2008). Temperament and character traits in patients with bipolar disorder and associations with comorbid alcoholism or anxiety disorders. Journal of Psychiatric Research 42, 569577.CrossRefGoogle ScholarPubMed
Nery, FG, Hatch, JP, Nicoletti, MA, Monkul, ES, Najt, P, Matsuo, K, Cloninger, CR, Soares, JC (2009). Temperament and character traits in major depressive disorder: influence of mood state and recurrence of episodes. Depression and Anxiety 26, 382388.CrossRefGoogle ScholarPubMed
Nowakowska, C, Strong, CM, Santosa, CM, Wang, PW, Ketter, TA (2005). Temperamental commonalities and differences in euthymic mood disorder patients, creative controls, and healthy controls. Journal of Affective Disorders 85, 207215.CrossRefGoogle ScholarPubMed
Osher, Y, Cloninger, CR, Belmaker, RH (1996). TPQ in euthymic manic-depressive patients. Journal of Psychiatric Research 30, 353357.CrossRefGoogle ScholarPubMed
Osher, Y, Lefkifker, E, Kotler, M (1999). Low persistence in euthymic manic-depressive patients: a replication. Journal of Affective Disorders 53, 8790.CrossRefGoogle ScholarPubMed
Pelissolo, A, Mallet, L, Baleyte, JM, Michel, G, Cloninger, CR, Allilaire, JF, Jouvent, R (2005). The Temperament and Character Inventory-Revised (TCI-R): psychometric characteristics of the French version. Acta Psychiatrica Scandinavica 112, 126133.CrossRefGoogle ScholarPubMed
Richter, J, Eisemann, M, Richter, G (2000). Temperament and character during the course of unipolar depression among inpatients. European Archives of Psychiatry and Clinical Neuroscience 250, 4047.CrossRefGoogle ScholarPubMed
Rihmer, Z, Akiskal, K, Rihmer, A, Akiskal, H (2010). Current research on affective temperaments. Current Opinion in Psychiatry 23, 1218.CrossRefGoogle ScholarPubMed
Sato, T, Narita, T, Hirano, S, Kusunoki, K, Sakado, K, Uehara, T (2001). Is interpersonal sensitivity specific to non-melancholic depressions? Journal of Affective Disorders 64, 133144.CrossRefGoogle ScholarPubMed
Savitz, J, Ramesar, R (2006). Personality: is it a viable endophenotype for genetic studies of bipolar affective disorder? Bipolar Disorders 8, 322337.CrossRefGoogle ScholarPubMed
Savitz, J, van der Merwe, L, Ramesar, R (2008). Dysthymic and anxiety-related personality traits in bipolar spectrum illness. Journal of Affective Disorders 109, 305311.CrossRefGoogle ScholarPubMed
Sayin, A, Kuruoglu, AC, Yazici Gulec, M, Aslan, S (2007). Relation of temperament and character properties with clinical presentation of bipolar disorder. Comprehensive Psychiatry 48, 446451.CrossRefGoogle ScholarPubMed
Serretti, A, Mandelli, L, Lorenzi, C, Landoni, S, Calati, R, Insacco, C, Cloninger, CR (2006). Temperament and character in mood disorders: influence of DRD4, SERTPR, TPH and MAO-A polymorphisms. Neuropsychobiology 53, 9–16.CrossRefGoogle ScholarPubMed
Strakowski, SM, Faedda, GL, Tohen, M, Goodwin, DC, Stoll, AL (1992). Possible affective-state dependence of the Tridimensional Personality Questionnaire in first-episode psychosis. Psychiatry Research 41, 215226.CrossRefGoogle ScholarPubMed
Vuorilehto, M, Melartin, T, Isometsä, E (2005). Depressive disorders in primary care: recurrent, chronic, and co-morbid. Psychological Medicine 35, 673682.CrossRefGoogle ScholarPubMed
Vuorilehto, MS, Melartin, TK, Isometsä, ET (2009). Course and outcome of depressive disorders in primary care: a prospective 18-month study. Psychological Medicine 39, 16971707.CrossRefGoogle ScholarPubMed
Vuorilehto, MS, Melartin, TK, Rytsälä, HJ, Isometsä, ET (2007). Do characteristics of patients with major depressive disorder differ between primary and psychiatric care? Psychological Medicine 37, 893904.CrossRefGoogle ScholarPubMed
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589593.CrossRefGoogle ScholarPubMed
Young, LT, Bagby, RM, Cooke, RG, Parker, JD, Levitt, AJ, Joffe, RT (1995). A comparison of Tridimensional Personality Questionnaire dimensions in bipolar disorder and unipolar depression. Psychiatry Research 58, 139143.CrossRefGoogle ScholarPubMed
Young, RC, Biggs, JT, Ziegler, VE, Meyer, DA (1978). A rating scale for mania: reliability, validity and sensitivity. British Journal of Psychiatry 133, 429435.CrossRefGoogle ScholarPubMed
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