Temperament and prodromal symptoms prior to first manic/hypomanic episodes: Results from a pilot study

Abstract

Results Among 39 subjects (36.1±9.9 years, females=59%, bipolar-I=62%) 100% and 92.3% reported subthreshold mania (mean=7.4±2.9) or subthreshold depressive symptoms (mean=2.4±1.5), and 87.2% and 43.6% reported general psychopathology (mean=3.2±2.0) or subthreshold psychotic symptoms (mean=0.7±1.0) prior to their first hypo-/manic episode. Subjects with higher cyclothymic and irritable temperament scores showed more subthreshold symptoms prior to the first manic/hypomanic episode, mainly subthreshold hypo-/manic symptoms (cyclothymic temperament r=0.430; p=0.006; irritable temperament r=0.330; p=0.040), general psychopathology symptoms (cyclothymic temperament r=0.316; p=0.05; irritable temperament r=0.349; p=0.029) and subthreshold psychotic symptoms (cyclothymic temperament r=0.413; p=0.009). In regression analyses, cyclothymic temperament explained 16.1% and 12.5% of the variance of the BPSS-R total score (p=0.045) and psychosis subscore (p=0.029). Background Prodromal symptoms prior to first episode mania hypomania have been reported. However, the relationship between temperament and manic hypomanic prodromal symptoms has not been investigated. We hypothesized that subjects scoring higher on cyclothymic and irritable temperament scales show more manic/hypomanic prodromal symptoms. Method Euthymic patients diagnosed with bipolar-I or -II disorder within 8 years underwent retrospective assessments with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire (TEMPS-A) and the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R). Limitations Retrospective study, no control group, small sample size. Conclusion We present data, which indicate a relationship between cyclothymic and irritable temperament and prodromal symptoms prior to the first manic/hypomanic episode. These findings support the notion that assessing cyclothymic temperament to identify people at-risk of developing bipolar-I and -II disorder may help to increase the predictive validity of applied at-risk criteria. © 2014 Elsevier B.V. All rights reserved.