Premorbid personality aspects in mood and schizophrenic disorders

Illness perceptions and personality traits of patients with mental disorders: the impact of ethnicity

OBJECTIVE

To identify differences and similarities between immigrants of Turkish origin and native German patients in therapeutically relevant dimensions such as subjective illness perceptions and personality traits.

METHOD

Turkish and native German mentally disordered in-patients were interviewed in three psychiatric clinics in Hessen, Germany. The Revised Illness Perception Questionnaire (IPQ-Revised) and the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI) were used. Differences of scales and similarities by k-means cluster analyses were estimated.

RESULTS

Of the 362 total patients, 227 (123 immigrants and 104 native Germans) were included. Neither demographic nor clinical differences were detected. Socioeconomic gradients and differences on IPQ-R scales were identified. For each ethnicity, the cluster analysis identified four different patient types based on NEO-FFI and IPQ-R scales. The patient types of each ethnicity appeared to be very similar in their structure, but they differed solely in the magnitude of the cluster means on included subscales according to ethnicity.

CONCLUSION

When subjective illness perceptions and personality traits are considered together, basic patient types emerge independent of the ethnicity. Thus, the ethnical impact on patient types diminishes and a convergence was detected.

Is there evidence for social rhythm instability in people at risk for affective disorders?

Social rhythm disruptions are thought to be related to the etiology of affective symptoms. 'Hypomanic personality' and 'rigidity' are hypothesized to be risk factors for affective disorders. We examined whether people scoring high on such scales would demonstrate instability of social rhythms and sleep. In a short-term prospective diary study with one group factor, the following three groups were selected from a non-university student sample: 'bipolar risk' (scoring high on the 'Hypomanic Personality Scale'; n=56); 'Unipolar risk' (scoring high on the 'Rigidity Scale'; n=37); and a control group (scoring low on both scales; n=48). The participants completed ratings of their activities and sleep for 28 days. People at risk for bipolar disorders showed a lower regularity of daily activities than controls. Their sleeping pattern was not characterized by fewer but by more variable hours of sleep. The unipolar risk group did not differ from the control group at all. Despite some limitations, there is partial evidence for social rhythm and sleep irregularities in people putatively at risk for bipolar disorders. Further research is, however, needed to replicate and extend these results.

Reliability and validity of TEMPS-A in a Japanese non-clinical population: application to unipolar and bipolar depressives

BACKGROUND

In Japan, TEMPS-A has gathered much attention, because Kraepelin's concepts on "fundamental states" of mood disorder and temperaments have been widely respected.

METHOD

TEMPS-A was translated into Japanese (and after the approval of the English back translation by H.S.A.), it was administered to 1391 non-clinical subjects, and 29 unipolar and 30 bipolar patients in remission. Of the non-clinical sample, 426 were readministered the instrument again in 1 month. A control group matched for gender and age was drawn from the non-clinical sample.

RESULTS

Regarding test-retest reliability, Spearman's coefficients for depressive, cyclothymic, hyperthymic, irritable and anxious temperaments were 0.79, 0.84, 0.87, 0.81 and 0.87, respectively; regarding internal consistency, Cronbach's alpha coefficients were 0.69, 0.84, 0.79, 0.83 and 0.87, respectively. The unipolar and bipolar groups showed significantly higher depressive, cyclothymic and anxious temperament scores than the control group. Curiously, the bipolar group showed significantly lower hyperthymic score than the control group; irritable temperament scores showed no significant differences. Depressive, cyclothymic, irritable and anxious temperament scores showed significant correlations with each other. Between the unipolar and bipolar groups, there was little difference regarding the temperament scores. Also the inter-temperament correlations showed the same pattern in the unipolar and bipolar groups.

LIMITATION

The clinically well cohort was 70% male.

CONCLUSION

TEMPS-A showed a high reliability and validity (internal consistency) in a Japanese non-clinical sample. By and large, the hypothesized five temperament structure was upheld. Depressive, cyclothymic and anxious temperaments showed concurrent validity with mood disorder. Irritable temperament may represent a subtype of depressive, cyclothymic or anxious temperaments. There may be a temperamental commonality between unipolar and bipolar disorders. TEMPS-A will open new possibilities for international research on mood disorder and personality traits.

The Munich vulnerability study on affective disorders: premorbid psychometric profile of affected individuals

OBJECTIVE

We conducted a longitudinal high-risk study to identify psychometric vulnerability markers for affective disorders.

METHOD

We examined 82 healthy subjects [high-risk probands (HRPs)] with at least one first-degree relative suffering from an affective disorder. The premorbid psychometric profile of 20 HRPs who developed a psychiatric disorder during follow-up was compared with the profile of control subjects without personal and family history of psychiatric disorders matched for age and gender.

RESULTS

Somatization, complaints (vegetative lability), and perception of strain are increased in HRPs who developed a psychiatric disorder. These alterations were not influenced by the time interval until the onset of the disorder.

CONCLUSION

The premorbid psychometric profile in subjects at high risk for affective disorders is characterized by somatization, complaints, and elevated perception of strain. Together with previous findings our results suggest that these alterations can be regarded as potential vulnerability markers for affective disorders.

Myers Briggs Type Indicator and Tridimensional Personality Questionnaire differences between bipolar patients and unipolar depressed patients

OBJECTIVES

The current study was designed to compare personality differences between bipolar patients and unipolar depressed patients, as evaluated on the Myers Briggs Type Indicator (MBTI) and the Tridimensional Personality Questionnaire (TPQ).

METHODS

A group of bipolar and a group of unipolar depressed patients filled out the MBTI, the TPQ, the Beck Depression Inventory, and the CAGE questionnaire. The two groups were compared with each other as to responses on the above surveys, and subgroups of bipolar depressed and bipolar patients with manic symptoms were also compared.

RESULTS

Bipolar patients were found to be significantly more extroverted (p = 0.004) and less judging (p = 0.007) on the MBTI. They were significantly more novelty seeking (p = 0.004) and less harm avoidant (p = 0.002) on the TPQ. Of the above differences, only the TPQ harm avoidance scale appeared strongly linked to the patients' level of depression.

CONCLUSION

Significant differences in personality exist between bipolar disorder and unipolar depressed patients.

Personality in patients with affective disorders and their relatives

BACKGROUND

In studies of both patients and high-risk subjects, particular patterns of personality have been found to be associated with affective disorders. Neuroticism and features of the melancholic type of personality seem to be risk factors for depression while premorbid features of the manic type of personality predominate in patients with more manic than depressive episodes. While neuroticism prevails in the majority of mental disorders, the 'affective' personality variants appear to be more specifically associated with affective disorders.

METHODS

Personality features were investigated in 122 recovered patients with affective disorders, 58 first-degree relatives (high-risk subjects (HR)) and in the respective control groups (n=48; n=29). Patients were subdivided into: unipolar depression (melancholic subtype); bipolar II; bipolar I with more depressive episodes and bipolar I with more manic episodes. Personality measures were based on the Biographical Personality Interview (BPI) and the Munich Personality Test (MPT).

RESULTS

The melancholic personality type (BPI) decreased from the unipolar depressives to the mainly manic group, while features of the manic type increased. MPT scores failed to discriminate between subgroups of patients. HR were significantly more introverted and had a stronger orientation towards social norms than controls according to the MPT, and showed a tendency towards the melancholic type according to the BPI.

LIMITATIONS

The sizes of some groups or subgroups are relatively small. Therefore, they have to be enlarged in the continuation of the study so as to increase the power of the statistical tests and thus to ascertain the robustness of the results.

CONCLUSION

Features of the typus melancholicus seem to be a risk factor for depression. The identification of highly predictive risk factors provides an opportunity for the development of prevention programs.