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Seeberg Nielsen L, Krarup Larsen S, Csillag C, Mortensen EL, Vinberg M. 'Personality and bipolar disorder: personality profiles of patients with remitted bipolar disorder and matched controls in a Danish sample'. Nord J Psychiatry 2023; 77:661-668. [PMID: 37191348 DOI: 10.1080/08039488.2023.2210137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/20/2023] [Accepted: 04/30/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND The aim of the study was to investigate whether patients with bipolar disorder (BD) in remission differ in personality traits compared with a healthy control group. METHODS A sample of patients with BD (n = 44) was compared with an individually matched control group (n = 44) using the Danish version of the Revised NEO Personality Inventory (NEO PI-R). Paired t-tests were used to analyze differences between the two groups and multiple regression models to evaluate predictors of NEO scores in the patient group. RESULTS Patients with BD reported significantly higher scores on both Neuroticism and Openness to Experience and lower scores on Conscientiousness. No differences were found on Extraversion and Agreeableness. The effect size for Neuroticism and its facets had a range from 0.77 to 1.45 SD.Statistically significant group differences were seen on 15 of 30 lower-level traits within all five high-order dimensions. There were large effect sizes for Trust (0.77) and Self-discipline (0.85), while the other statistically significant group differences were smaller with effect sizes in the range from 0.43 to 0.74 SD.However, patients with BD showed a profile with high-order dimensions and lower-level traits within one standard deviation from the mean score except for the lower-level trait Depression. CONCLUSIONS Our findings suggest that patients with BD differ from healthy control persons with respect to higher levels of Neuroticism, Openness to Experience and lower scores on Agreeableness and on Conscientiousness, but prospective studies are needed to evaluate the implications of this finding.
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Affiliation(s)
- Lene Seeberg Nielsen
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre North Zealand, Copenhagen University Hospital, Mental health services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Sarah Krarup Larsen
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre North Zealand, Copenhagen University Hospital, Mental health services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Claudio Csillag
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre North Zealand, Copenhagen University Hospital, Mental health services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Unit of Medical Psychology, Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre North Zealand, Copenhagen University Hospital, Mental health services in the Capital Region of Denmark, Copenhagen, Denmark
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Kelman J, Thacher A, Hossepian K, Pearlstein J, Geraghty S, Cosgrove VE. Personality and pediatric bipolar disorder: Toward personalizing psychosocial intervention. J Affect Disord 2020; 275:311-318. [PMID: 32734924 DOI: 10.1016/j.jad.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/30/2020] [Accepted: 07/04/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Previous research suggests that challenging temperament characteristics (i.e., low mood, irritability and rigidity) are associated with risk for the development of Pediatric Bipolar Disorder (PBD). This study aimed to investigate the connection between PBD and discrete dimensions of the Five Factor Model (FFM) of personality. METHODS Youth diagnosed with PBD I, II, or NOS, at high risk for the disorder (BD-HR) and healthy controls were recruited from the Child and Adolescent Psychiatry Outpatient Clinic at Stanford University School of Medicine. Researchers administered a personality inventory and evaluated current mood state. RESULTS BD and BD-HR youth scored lower in Emotional Regulation than did HC youth (F (3, 70) = 10.75, p < .001). Within the BD and BD-HR groups, youth with high depression scores scored lower on Extraversion (F (3, 70) = 8.62, p < .001) and Conscientiousness (F (3, 70) = 4.53, p < .01). LIMITATIONS A major limitation of this study is its cross-sectional design, precluding analysis of whether certain traits or clusters of traits predict PBD or other mood disorders. CONCLUSIONS Low Emotional Regulation, Conscientiousness, and Agreeableness were associated with PBD; this personality profile clinically corresponds with youth diagnosed with PBD who present with difficulty regulating their emotions, vulnerability to stress, and emotional reactivity. Future research examining personality characteristics in PBD may elucidate further a specific profile to aid clinicians in developing psychosocial interventions for youth with and at high risk of developing PBD.
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Affiliation(s)
- Jake Kelman
- Prevention and Intervention Laboratory, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304, United States; Menlo College, Atherton, CA, United States
| | - Abigail Thacher
- Prevention and Intervention Laboratory, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304, United States.
| | - Kristene Hossepian
- Prevention and Intervention Laboratory, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304, United States
| | - Jennifer Pearlstein
- Prevention and Intervention Laboratory, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304, United States; University of California Berkeley, United States
| | - Shauna Geraghty
- Prevention and Intervention Laboratory, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304, United States
| | - Victoria E Cosgrove
- Prevention and Intervention Laboratory, Division of Child and Adolescent Psychiatry, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94304, United States
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3
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Newton-Howes G, Foulds J. Personality Disorder and Alcohol Use Disorder: An Overview. Psychopathology 2018; 51:130-136. [PMID: 29466805 DOI: 10.1159/000486602] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 12/26/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Clinically, personality disorder (PD) commonly coexists with alcohol use disorder (AUD), although within mainstream mental health services both of these mental disorders are routinely overlooked. Despite a rich literature examining the interactions between AUD and personality functioning, personality traits, and PD, there remains conflicting evidence as to the degree of association and impact of one on the other. METHODS A narrative review and a synthesis of the literature were done. RESULTS The lifetime prevalence of AUD approaches 50% in some PD populations. The rates of PD in AUD populations are less clear but likely similar. Personality influences outcomes in AUD regardless of whether a categorical personality diagnosis or dimensional trait domain approach is taken. There are, however, no good data to inform clinicians on the impact of AUD on the outcomes of PD. Understanding the extent of this impact is complicated by the multiple tools used for diagnosis (of both PD and AUD) and the statistical methods used. Overall, caution is required in interpreting the data due to the quality of the current literature; however, comorbidity between the two disorders is likely significant and the impact of PD on AUD outcomes is sufficient to require consideration. CONCLUSIONS From a research perspective, better agreement on both diagnoses and outcomes is urgently needed to improve the overall quality of the evidence. Clinically, despite the limitations in the literature, it is unacceptable for PD services to ignore AUD and for AUD services not to screen for PD. Both are likely to have an impact on health and functioning and should be considered in routine reviews. A better conceptualization of the putative mechanisms of this interaction, as well as an understanding of the neurobiology and reasons for the impact on treatment outcomes, will help to move the field forward.
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Affiliation(s)
- Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Wellington, New Zealand
| | - James Foulds
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Dupuis M, Meier E, Rudaz D, Strippoli MPF, Castelao E, Preisig M, Capel R, Vandeleur CL. Psychiatric symptoms and response quality to self-rated personality tests: Evidence from the PsyCoLaus study. Psychiatry Res 2017; 252:118-125. [PMID: 28260642 DOI: 10.1016/j.psychres.2017.02.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/27/2017] [Accepted: 02/18/2017] [Indexed: 11/26/2022]
Abstract
Despite the fact that research has demonstrated consistent associations between self-rated measures of personality dimensions and mental disorders, little has been undertaken to investigate the relation between psychiatric symptoms and response patterns to self-rated tests. The aim of this study was to investigate the association between psychiatric symptoms and response quality using indices from our functional method. A sample of 1,784 participants from a Swiss population-based cohort completed a personality inventory (NEO-FFI) and a symptom checklist of 90 items (SCL-90-R). Different indices of response quality were calculated based on the responses given to the NEO-FFI. Associations among the responses to indices of response quality, sociodemographic characteristics and the SCL-90-R dimensions were then established. Psychiatric symptoms were associated with several important differences in response quality, questioning subjects' ability to provide valid information using self-rated instruments. As suggested by authors, psychiatric symptoms seem associated with differences in personality scores. Nonetheless, our study shows that symptoms are also related to differences in terms of response patterns as sources of differences in personality scores. This could constitute a bias for clinical assessment. Future studies could still determine whether certain subpopulations of subjects are more unable to provide valid information to self-rated questionnaires than others.
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Affiliation(s)
- Marc Dupuis
- Institute of Psychology, University of Lausanne, Geopolis Building, CH-1015 Lausanne, Switzerland.
| | - Emanuele Meier
- Institute of Psychology, University of Lausanne, Geopolis Building, CH-1015 Lausanne, Switzerland
| | - Dominique Rudaz
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Switzerland
| | - Marie-Pierre F Strippoli
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Switzerland
| | - Enrique Castelao
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Switzerland
| | - Martin Preisig
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Switzerland
| | - Roland Capel
- Institute of Psychology, University of Lausanne, Geopolis Building, CH-1015 Lausanne, Switzerland
| | - Caroline L Vandeleur
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Switzerland
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Mokros Ł, Witusik A, Michalska J, Łężak W, Panek M, Nowakowska-Domagała K, Antczak A, Pietras T. Sleep quality, chronotype, temperament and bipolar features as predictors of depressive symptoms among medical students. Chronobiol Int 2017; 34:708-720. [PMID: 28488895 DOI: 10.1080/07420528.2017.1316730] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The assessment of risk factors is a crucial step in the prevention and treatment of affective disorders and should encompass personal dispositions. The aim of this study was to assess the value of chronotype and temperament as independent predictors of depressive symptoms among medical students. The study surveyed 140 students of the Faculty of Medicine with a battery of questionnaires: the Beck Depression Index (BDI), Hypomania Checklist 32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), Chronotype Questionnaire and Eysenck Personality Questionnaire Revised. The results were tested using Pearson's correlation quotient and general linear model. Ten percent of the participants demonstrated a BDI score suggestive of clinically significant depressive symptoms. BDI score correlated positively with HCL-32 score. A rise in BDI was independently predicted by elevated Neuroticism and PSQI scores and morningness. Those effects were independent from each other and from other parameters of the model. The presence of depressive symptoms might be associated with bipolar features among medical students. Poor sleep quality predicted depressive symptoms, similarly to Neuroticism and independently of temperament and chronotype. Future studies on the associations between personal dispositions and mood disorders among medical students are required to help identify those at greater risk of developing affective illness. Effective prophylaxis and early intervention are warranted to ensure better treatment results.
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Affiliation(s)
- Łukasz Mokros
- a Department of Clinical Pharmacology , Medical University of Lodz , Lodz , Poland
| | - Andrzej Witusik
- b Department of Psychology , Faculty of Social Sciences, Piotrkow Trybunalski Division, Jan Kochanowski Memorial University of Humanities and Sciences , Piotrkow Trybunalski , Poland
| | - Julia Michalska
- c Clinical Pharmacology Students Scientific Circle, Department of Clinical Pharmacology , Medical University of Lodz , Lodz , Poland
| | - Wojciech Łężak
- d Department of Pharmacology and Toxicology , Medical University of Lodz , Lodz , Poland
| | - Michał Panek
- e Department of Internal Medicine , Asthma and Allergy, Medical University of Lodz , Lodz , Poland
| | - Katarzyna Nowakowska-Domagała
- f Department of Cognitive Science, Institute of Psychology , Faculty of Educational Sciences, University of Lodz , Lodz , Poland
| | - Adam Antczak
- g Department of General and Oncological Pulmonology , Medical University of Lodz , Lodz , Poland
| | - Tadeusz Pietras
- a Department of Clinical Pharmacology , Medical University of Lodz , Lodz , Poland
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Dupuis M, Capel R, Meier E, Rudaz D, Strippoli MPF, Castelao E, Preisig M, Vandeleur CL. Do bipolar subjects' responses to personality questionnaires lack reliability? Evidence from the PsyCoLaus study. Psychiatry Res 2016; 238:299-303. [PMID: 27086248 DOI: 10.1016/j.psychres.2016.02.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 12/26/2015] [Accepted: 02/21/2016] [Indexed: 12/12/2022]
Abstract
Differences in personality scores between subjects with and without mood disorders might result from response biases rather than specific personality traits per se. The aim of this study was to compare subjects with bipolar disorders (BPD) to non-bipolar subjects in terms of response quality to the NEO-FFI. Using data from the population-based cohort study PsyCoLaus, subjects were compared in terms of responses to the NEO-FFI, and indices of response quality were calculated. Hierarchical regression analyses were performed and controlled for sociodemographic factors, depressive episodes, dysthymia, anxiety disorders and substance use disorders. Consistent with the literature, subjects with BPD had higher scores in neuroticism and openness, and lower scores in conscientiousness. However, significant differences were measured for response reliability and validity. In particular, the indices of response quality including response reliability were lower in subjects with BPD suggesting that bipolar subjects might have more difficulty in providing consistent answers throughout questionnaires. However, regression models resulted in small associations between mania/hypomania and response quality, and showed that differences in response quality were mainly attributable to correlates of BPD instead of the presence of mania/hypomania itself. The current findings suggest that bipolar subjects' responses to questionnaires are biased, making them less reliable.
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Affiliation(s)
- Marc Dupuis
- Institute of Psychology, University of Lausanne, Switzerland.
| | - Roland Capel
- Institute of Psychology, University of Lausanne, Switzerland
| | - Emanuele Meier
- Institute of Psychology, University of Lausanne, Switzerland
| | - Dominique Rudaz
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Prilly, Switzerland
| | - Marie-Pierre F Strippoli
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Prilly, Switzerland
| | - Enrique Castelao
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Prilly, Switzerland
| | - Martin Preisig
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Prilly, Switzerland
| | - Caroline L Vandeleur
- Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital, Department of Psychiatry, Prilly, Switzerland
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7
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Relationship between personality disorder functioning styles and the emotional states in bipolar I and II disorders. PLoS One 2015; 10:e0117353. [PMID: 25625553 PMCID: PMC4307975 DOI: 10.1371/journal.pone.0117353] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 12/23/2014] [Indexed: 11/20/2022] Open
Abstract
Background Bipolar disorder types I (BD I) and II (BD II) behave differently in clinical manifestations, normal personality traits, responses to pharmacotherapies, biochemical backgrounds and neuroimaging activations. How the varied emotional states of BD I and II are related to the comorbid personality disorders remains to be settled. Methods We therefore administered the Plutchick – van Praag Depression Inventory (PVP), the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32), and the Parker Personality Measure (PERM) in 37 patients with BD I, 34 BD II, and in 76 healthy volunteers. Results Compared to the healthy volunteers, patients with BD I and II scored higher on some PERM styles, PVP, MDQ and HCL-32 scales. In BD I, the PERM Borderline style predicted the PVP scale; and Antisocial predicted HCL-32. In BD II, Borderline, Dependant, Paranoid (-) and Schizoid (-) predicted PVP; Borderline predicted MDQ; Passive-Aggressive and Schizoid (-) predicted HCL-32. In controls, Borderline and Narcissistic (-) predicted PVP; Borderline and Dependant (-) predicted MDQ. Conclusion Besides confirming the different predictability of the 11 functioning styles of personality disorder to BD I and II, we found that the prediction was more common in BD II, which might underlie its higher risk of suicide and poorer treatment outcome.
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Saunders EF, Nazir R, Kamali M, Ryan KA, Evans S, Langenecker S, Gelenberg AJ, McInnis MG. Gender differences, clinical correlates, and longitudinal outcome of bipolar disorder with comorbid migraine. J Clin Psychiatry 2014; 75:512-9. [PMID: 24816075 PMCID: PMC4211932 DOI: 10.4088/jcp.13m08623] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/07/2013] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Migraine is a common comorbidity of bipolar disorder and is more prevalent in women than men. We hypothesized comorbid migraine would be associated with features of illness and psychosocial risk factors that would differ by gender and impact outcome. METHOD A retrospective analysis was conducted to assess association between self-reported, physician-diagnosed migraine, clinical variables of interest, and mood outcome in subjects with DSM-IV bipolar disorder (N = 412) and healthy controls (N = 157) from the Prechter Longitudinal Study of Bipolar Disorder, 2005-2010. Informed consent was obtained from all participants. RESULTS Migraine was more common in subjects with bipolar disorder (31%) than in healthy controls (6%) and had elevated risk in bipolar disorder women compared to men (OR = 3.5; 95% CI, 2.1-5.8). In men, migraine was associated with bipolar II disorder (OR = 9.9; 95% CI, 2.3-41.9) and mixed symptoms (OR = 3.5; 95% CI, 1.0-11.9). In comparison to absence of migraine, presence of migraine was associated with an earlier age at onset of bipolar disorder by 2 years, more severe depression (β = .13, P = .03), and more frequent depression longitudinally (β = .13, P = .03). Migraine was correlated with childhood emotional abuse (P = .01), sexual abuse (P = 4 × 10⁻³), emotional neglect (P = .01), and high neuroticism (P = 2 × 10⁻³). Protective factors included high extraversion (P = .02) and high family adaptability at the trend level (P = .08). CONCLUSIONS Migraine is a common comorbidity with bipolar disorder and may impact long-term outcome of bipolar disorder, particularly depression. Clinicians should be alert for migraine comorbidity in women and in men with bipolar II disorder. Effective treatment of migraine may impact mood outcome in bipolar disorder as well as headache outcome. Joint pathophysiologic mechanisms between migraine and bipolar disorder may be important pathways for future study of treatments for both disorders.
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Affiliation(s)
- Erika F.H. Saunders
- Department of Psychiatry, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA,University of Michigan Department of Psychiatry, Ann Arbor, MI,University of Michigan Depression Center, Ann Arbor, MI
| | - Racha Nazir
- Department of Psychiatry, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Masoud Kamali
- University of Michigan Department of Psychiatry, Ann Arbor, MI,University of Michigan Depression Center, Ann Arbor, MI
| | - Kelly A. Ryan
- University of Michigan Department of Psychiatry, Ann Arbor, MI,University of Michigan Depression Center, Ann Arbor, MI
| | - Simon Evans
- University of Michigan Department of Psychiatry, Ann Arbor, MI,University of Michigan Depression Center, Ann Arbor, MI
| | - Scott Langenecker
- University of Michigan Department of Psychiatry, Ann Arbor, MI,University of Michigan Depression Center, Ann Arbor, MI,Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Alan J. Gelenberg
- Department of Psychiatry, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA
| | - Melvin G. McInnis
- University of Michigan Department of Psychiatry, Ann Arbor, MI,University of Michigan Depression Center, Ann Arbor, MI
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Belzeaux R, Ibrahim E, Azorin JM, Fakra E, Maurel M, Pringuey D, Kaladjian A, Dassa D, Corréard N, Dubois E, Micoulaud-Franchi JA, Cermolacce M. Modèles physiopathologiques des états mixtes. Encephale 2013; 39 Suppl 3:S167-71. [DOI: 10.1016/s0013-7006(13)70117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Coulston CM, Bargh DM, Tanious M, Cashman EL, Tufrey K, Curran G, Kuiper S, Morgan H, Lampe L, Malhi GS. Is coping well a matter of personality? A study of euthymic unipolar and bipolar patients. J Affect Disord 2013; 145:54-61. [PMID: 22921480 DOI: 10.1016/j.jad.2012.07.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/16/2012] [Accepted: 07/16/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Euthymic bipolar disorder (BD) patients often demonstrate better clinical outcomes than remitted patients with unipolar illness (UP). Reasons for this are uncertain, however, personality and coping styles are each likely to play a key role. This study examined differences between euthymic BD and UP patients with respect to the inter-relationship between personality, coping style, and clinical outcomes. METHODS A total of 96 UP and 77 BD euthymic patients were recruited through the CADE Clinic, Royal North Shore Hospital in Sydney, and assessed by a team comprising Psychiatrists and Psychologists. They underwent a structured clinical diagnostic interview, and completed self-report measures of depression, anxiety, stress, personality, coping, social adjustment, self-esteem, dysfunctional attitudes, and fear of negative evaluation. RESULTS Compared to UP, BD patients reported significantly higher scores on levels of extraversion, adaptive coping, self-esteem, and lower scores on trait anxiety and fear of negative evaluation. Extraversion correlated positively with self-esteem, adaptive coping styles, and negatively with trait anxiety and fear of negative evaluation. Trait anxiety and fear of negative evaluation correlated positively with eachother, and both correlated negatively with self-esteem and adaptive coping styles. Finally, self-esteem correlated positively with adaptive coping styles. LIMITATIONS The results cannot be generalised to depressive states of BD and UP, as differences in the course of illness and types of depression are likely to impact on coping and clinical outcomes, particularly for BD. CONCLUSIONS During remission, functioning is perhaps better 'preserved' in BD than in UP, possibly because of the protective role of extraversion which drives healthier coping styles.
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Affiliation(s)
- Carissa M Coulston
- CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, Australia
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11
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Clark AA, Owens GP. Attachment, personality characteristics, and posttraumatic stress disorder in U.S. veterans of Iraq and Afghanistan. J Trauma Stress 2012; 25:657-64. [PMID: 23225032 DOI: 10.1002/jts.21760] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
U.S. veterans of Iraq and/or Afghanistan (N = 116) completed an Internet survey with questions related to attachment style in intimate relationships, personality factors, and posttraumatic stress disorder (PTSD). Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, and the International Personality Item Pool Big Five Short Form Questionnaire. Most participants were male and Caucasian. Hierarchical linear regression analysis results indicated that emotional stability (β = -.46, p < .001) and attachment avoidance (β = .20, p < .05) were associated with PTSD symptom severity (adjusted R(2) = .63). An interaction between conscientiousness and attachment anxiety was found (β = -.26, p < .001; ΔR(2) = .06), with secure attachment moderating the relationship between conscientiousness and PTSD symptom severity. Results of this study indicate that emotional stability, conscientiousness, and secure relationship attachment styles (low attachment anxiety and avoidance) are important for postcombat mental health.
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Affiliation(s)
- Allison A Clark
- Department of Psychology, University of Tennessee, Knoxville, TN 37996-0900, USA.
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12
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Saunders EFH, Fitzgerald KD, Zhang P, McInnis MG. Clinical features of bipolar disorder comorbid with anxiety disorders differ between men and women. Depress Anxiety 2012; 29:739-46. [PMID: 22461133 PMCID: PMC3650482 DOI: 10.1002/da.21932] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Revised: 01/20/2012] [Accepted: 01/28/2012] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Anxiety disorders are commonly comorbid with bipolar disorder (BP) and may worsen course of illness, but differential impact of specific anxiety disorders in men and women remains unknown. METHODS We measured the impact of comorbid panic disorder (PD), social phobia, specific phobia, and obsessive-compulsive disorder (OCD) in 460 women and 276 men with Bipolar I Disorder (BPI) or schizoaffective disorder, bipolar type from the National Institute of Mental Health Bipolar Genetics Initiative. We compared clinical characteristics in BP with and without each anxiety disorder in men and women separately correcting for family relatedness. RESULTS Comorbid PD, OCD, and specific phobia were more common in women with BP than men. Comorbid social phobia correlated with increased risk of alcohol abuse in BP women, but not men. Women with comorbid PD attended fewer years of school. Comorbidity with OCD was associated with earlier age at the onset of BP for both genders. Comorbid PD, OCD, and specific phobia were associated with more antidepressant trials in BP, across both genders, compared to BP patients without these anxiety disorders. CONCLUSION In BP, comorbid anxiety disorders are associated with increased risk for functional impairment, and women had differently associated risks than men. Clinicians should be aware of an increased risk for comorbid PD, OCD, and specific phobia in women with BP, and an increased risk of alcohol abuse in women with BD and comorbid social phobia.
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Affiliation(s)
- Erika F. H. Saunders
- Department of Psychiatry, College of Medicine, Pennsylvania State University, Hershey, Pennsylvania
,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
,Depression Center, University of Michigan, Ann Arbor, Michigan
,Correspondence to: Erika F. H. Saunders, Department of Psychiatry, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, HP16 22 Northeast Drive, Suite 205, Hershey, PA 17033.
| | - Kate D. Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
,Depression Center, University of Michigan, Ann Arbor, Michigan
| | - Peng Zhang
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
,Department of Bioinformatics, University of Michigan, Ann Arbor, Michigan
| | - Melvin G. McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
,Depression Center, University of Michigan, Ann Arbor, Michigan
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Fletcher K, Parker G, Barrett M, Synnott H, McCraw S. Temperament and personality in bipolar II disorder. J Affect Disord 2012; 136:304-9. [PMID: 22154887 DOI: 10.1016/j.jad.2011.11.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 11/14/2011] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is limited research examining temperament and personality in bipolar II disorder. We sought to determine any over-represented temperament and personality features in bipolar II disorder compared to other affective groups. METHOD Scores on a self-report measure of temperament and personality were examined in a sample of 443 participants diagnosed with unipolar, bipolar I and bipolar II disorder. RESULTS After controlling for age, gender, age of depression onset and current depression severity, those with bipolar II disorder were characterized by higher irritability, anxious worrying, self-criticism and interpersonal sensitivity scores, and with lower social avoidance scores compared to unipolar participants. No differences were found between bipolar sub-types on any temperament and personality sub-scales. Limitations included the lack of a control group, a relatively small sample of bipolar I participants, and with the cross-sectional design disallowing conclusions regarding premorbid personality traits as opposed to illness 'scarring' effects. CONCLUSIONS Further research should seek to clarify whether certain temperament and personality styles are over-represented in bipolar II disorder. Any over-represented characteristics may assist with diagnostic differentiation from phenomenologically similar conditions and lead to more appropriate clinical management.
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Affiliation(s)
- Kathryn Fletcher
- School of Psychiatry, University of New South Wales, NSW, Australia.
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Evans SJ, Prossin AR, Harrington GJ, Kamali M, Ellingrod VL, Burant CF, McInnis MG. Fats and factors: lipid profiles associate with personality factors and suicidal history in bipolar subjects. PLoS One 2012; 7:e29297. [PMID: 22253709 PMCID: PMC3258247 DOI: 10.1371/journal.pone.0029297] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 11/24/2011] [Indexed: 02/01/2023] Open
Abstract
Polyunsaturated fatty acids (PUFA) have shown efficacy in the treatment of bipolar disorder, however their specific role in treating the illness is unclear. Serum PUFA and dietary intakes of PUFA associate with suicidal behavior in epidemiological studies. The objective of this study was to assess serum n-3 and n-6 PUFA levels in bipolar subjects and determine possible associations with suicidal risk, including suicidal history and relevant personality factors that have been associated with suicidality. We studied 27 bipolar subjects using the NEO-PI to assess the big five personality factors, structured interviews to verify diagnosis and assess suicidal history, and lipomics to quantify n-3 and n-6 PUFA in serum. We found positive associations between personality factors and ratios of n-3 PUFA, suggesting that conversion of short chain to long chain n-3s and the activity of enzymes in this pathway may associate with measures of personality. Thus, ratios of docosahexaenoic acid (DHA) to alpha linolenic acid (ALA) and the activity of fatty acid desaturase 2 (FADS2) involved in the conversion of ALA to DHA were positively associated with openness factor scores. Ratios of eicosapentaenoic acid (EPA) to ALA and ratios of EPA to DHA were positively associated with agreeableness factor scores. Finally, serum concentrations of the n-6, arachidonic acid (AA), were significantly lower in subjects with a history of suicide attempt compared to non-attempters. The data suggest that specific lipid profiles, which are controlled by an interaction between diet and genetics, correlate with suicidal history and personality factors related to suicidal risk. This study provides preliminary data for future studies to determine whether manipulation of PUFA profiles (through diet or supplementation) can affect personality measures and disease outcome in bipolar subjects and supports the need for further investigations into individualized specific modulations of lipid profiles to add adjunctive value to treatment paradigms.
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Affiliation(s)
- Simon J Evans
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America.
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