The importance of measures of affective temperaments in genetic studies of mood disorders

https://doi.org/10.1016/0022-3956(92)90032-JGet rights and content

Abstract

Collaboration between the University of Pisa, Italy, and the University of Tennessee, Memphis, U.S.A., on patients presenting with major depressive episodes (in the absence of nonaffective psychiatric illness) focused on the detection of depressive and hyperthymic temperaments. From our data on symptomatology, family history and course of 538 such patients, several findings emerge of cardinal relevance to genetic studies. Hyperthymic temperament, observed more commonly in men, appears as one pole of an attenuated form of manic-depressive illness. Thus, major depressives with this temparament have high rates of bipolar family history, even in the absence of hypomanic and manic episodes. The depressive temperament, more prevalent in women, is correlated with earlier onset and higher number of depressive episodes, greater severity of the Hamilton Rating Scale for Depression (HAM-D), as well as higher familial loading for mood disorders, compared with major depressives without this temperament. Building on Akiskal's latest model on the multifactorial origin of mood disorders, we submit that these temperamental dysregulations constitute the intermediate step between predisposing familial-genetic factors in affective illness and gender-related clinical expressions of mood disorders. The authors recommend that future high-risk prospective studies and genetic investigations should include measures of affective temperament.

References (43)

  • H.S. Akiskal et al.

    Cyclothymic temperamental disorders

    Psychiatric Clinics of North America

    (1979)
  • J. Endicott et al.

    Bipolar II: combine or keep separate?

    Journal of Affective Disorders

    (1985)
  • H.S. Akiskal

    The bipolar spectrum: new concepts in classification and diagnosis

  • H.S. Akiskal

    Diagnosis and classification of affective disorders: new insights from clinical and laboratory approaches

    Psychiatric Developments

    (1983)
  • H.S. Akiskal

    Characterological manifestations of affective disorders. Toward a new conceptualization

    Integrative Psychiatry

    (1984)
  • H.S. Akiskal

    Validating personality types

  • H.S. Akiskal

    An integrative perspective on recurrent mood disorders: The mediating role of personality

  • H.S. Akiskal et al.

    Reassessing the prevalence of bipolar disorders: Clinical significance and artistic creativity

    Psychiatry and Psychobiology

    (1988)
  • H.S. Akiskal et al.

    Cyclothymic, hyperthymic and depressive temperaments as subaffective variants of mood disorders

  • H.S. Akiskal et al.

    Borderline: an adjective in search of a noun

    Journal of Clinical Psychiatry

    (1985)
  • H.S. Akiskal et al.

    Cyclothymic disorder: Validating criteria for inclusion in the bipolar affective group

    American Journal of Psychiatry

    (1977)
  • H.S. Akiskal et al.

    Affective disorders in referred children and younger siblings of manic depressives: mode of onset and prospective course

    Archives of General Psychiatry

    (1985)
  • H.S. Akiskal et al.

    Criteria for the “soft” bipolar spectrum: treatment implications

    Psychopharmacology Bulletin

    (1987)
  • H.S. Akiskal et al.

    Characterological depressions: Clinical and sleep EEG findings separating “subaffective dysthymias” from “character-spectrum” disorders

    Archives of General Psychiatry

    (1980)
  • American Psychiatric Association

    Diagnostic and statistical manual of mental disorders

    (1980)
  • American Psychiatry Association

    Diagnostic and statistical manual of mental disorders

    (1987)
  • J. Angst

    The etiology and nosology of endogenous depressive psychoses

    Foreign Psychiatry

    (1966/73)
  • J. Angst et al.

    The course of unipolar and bipolar affective disorders

  • A. Bertelsen et al.

    A Danish twin study of manic depressive disorders

    British Journal of Psychiatry

    (1977)
  • H.G. Boyd et al.

    Epidemiology of affective disorders: A re-examination and future directions

    Archives of General Psychiatry

    (1981)
  • G.B. Cassano et al.

    Psychopathology, temperament, and past course in primary major depressions. 2. Toward a redefinition of bipolarity with a new semistructured interview for depression

    Psychopathology

    (1989)
  • Cited by (0)

    View full text