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Rogers DL, Tanaka MJ, Cosgarea AJ, Ginsburg RD, Dreher GM. How Mental Health Affects Injury Risk and Outcomes in Athletes. Sports Health 2024; 16:222-229. [PMID: 37326145 PMCID: PMC10916780 DOI: 10.1177/19417381231179678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
CONTEXT The importance of mental health among athletes is becoming more recognized and valued. Athletes experience symptoms of depression, anxiety, and related mental health disorders at rates similar to those of the general population, but because athletes face unique cultural and environmental pressures, such disorders are exacerbated in the context of an injury. Furthermore, we review the less well-known evidence that mental health disorders in athletes are associated with an increased risk of injury. We discuss the increasing awareness of the deficiencies in mental health support for athletes, which has been especially highlighted during the COVID-19 pandemic as well as in prominent professional and Olympic athletes, and describe both internal and external barriers to appropriate care. EVIDENCE ACQUISITION We searched PubMed for pertinent peer-reviewed studies. STUDY DESIGN Clinical review. LEVEL OF EVIDENCE Level 5. RESULTS There is a known psychological response to injury that can prolong recovery from musculoskeletal injury; conversely, mental health disorders in athletes are not only associated with an increased injury risk but also portend poorer outcomes subsequently, including prolonged recovery times, increased rates of injury recurrence, decreased rates of return to sport, and reduced performance upon return. Because of inherent barriers to appropriate care of athletes, including identification, stigma, and resource availability, there are currently various ongoing efforts nationally to create and implement initiatives regarding athlete mental health screening, support systems, and directed interventions to address the inextricably linked physical and mental health of athletes. CONCLUSION Athletic injury negatively impacts the mental health of athletes. Likewise, mental health can and does influence athletic performance and is also intimately tied to the risk of athletic injury, thus creating a complex cycle with inability to separate physical and mental health.
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Affiliation(s)
- Davis L Rogers
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Miho J Tanaka
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Andrew J Cosgarea
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard D Ginsburg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Geoffrey M Dreher
- Department of Orthopaedic Surgery, The Johns Hopkins School of Medicine, Baltimore, Maryland
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Young L, Esagoff AI, Reisch A, Bernick CB, Peters ME, Narapareddy BR. Cocaine history and impulsiveness in professional boxers and mixed martial arts fighters. Am J Addict 2024; 33:92-95. [PMID: 37670433 DOI: 10.1111/ajad.13479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND/OBJECTIVES Impulsiveness is linked to cocaine history (CH) in the general population and greater fight exposure in professional fighters. Among fighters, no previous studies have quantified CH or investigated its relationship with impulsiveness. METHODS Adjusted multivariable regressions were utilized to examine the relationship between CH and impulsiveness in 335 fighters from the Professional Fighters Brain Health Study. RESULTS Twenty percent of fighters reported CH. CH was significantly associated with impulsiveness overall and on three subscales. DISCUSSION/CONCLUSION Cocaine's prevalence and significant association with impulsiveness in fighters merit further study. SCIENTIFIC SIGNIFICANCE We quantify CH and demonstrate its significant association with impulsiveness in professional fighters for the first time.
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Affiliation(s)
- Lisa Young
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aaron I Esagoff
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Anne Reisch
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Charles B Bernick
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA
| | - Matthew E Peters
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bharat R Narapareddy
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
- Institute of Living, Hartford Hospital, Hartford, Connecticut, USA
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Carta MG, Kalcev G, Fornaro M, Pinna S, Gonzalez CIA, Nardi AE, Primavera D. Does Screening for Bipolar Disorders Identify a "Dysregulation of Mood, Energy, and Social Rhythms Syndrome" (DYMERS)? A Heuristic Working Hypothesis. J Clin Med 2023; 12:5162. [PMID: 37568562 PMCID: PMC10419483 DOI: 10.3390/jcm12155162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/31/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this paper is to verify if people with a positive score on the Mood Disorder Questionnaire (MDQ) without comorbidity of mood disorders showed a worse level of Health-related Quality of life (HRQol) compared to a control-matched sample of MDQ negatives, identifying a specific syndrome. This is a case-control study based on a database from a community survey. Cases: MDQ-positive without mood disorders; Controls: MDQ negatives matched by sex, age, and psychiatric diagnosis according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. Tools: MDQ, the Advanced Neuropsychiatric Tools and Assessment Schedule (ANTAS) semi-structured interview for psychiatric diagnosis, and the Health Survey Short Form (SF-12) for measuring HRQol. People scoring positive on the MDQ without a diagnosis of mood disorders showed significantly lower scores on the SF-12 compared to people of the same age and of the same sex with an equal diagnosis of psychiatric disorders not related to mood disorders (35.21 ± 6.30 vs. 41.48 ± 3.39, p < 0.0001). In the debate whether a positive score on the MDQ selects an area of "malaise" due to the presence of disorders differing from Bipolar Disorders, or if a positive score on the MDQ may be considered a "subthreshold" form of bipolar disorder in people who may later develop bipolar disorder, a third hypothesis can be advanced, i.e., that a positive score on the MDQ identifies a specific "Dysregulation of Mood, Energy, and Social Rhythms Syndrome" (DYMERS), characterized by a considerable amount of suffering and not attributable to other disorders, and which might represent a trigger for the previously mentioned disorders with which a positive score on the MDQ is associated, probably including, in severe conditions, bipolar disorder.
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (M.G.C.); (S.P.); (D.P.)
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (M.G.C.); (S.P.); (D.P.)
| | - Michele Fornaro
- Department of Psychiatry, Federico II University of Naples, 80126 Naples, Italy;
| | - Samantha Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (M.G.C.); (S.P.); (D.P.)
| | - Cesar Ivan Aviles Gonzalez
- Nursing Program, Faculty of Health Sciences, Universidad Popular del Cesar, Sede Sabanas, Valledupar 20002, Colombia;
| | - Antonio Egidio Nardi
- Laboratory Panic and Respiration, Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro 22725, Brazil;
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy; (M.G.C.); (S.P.); (D.P.)
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Millán-Sánchez A, Madinabeitia I, de la Vega R, Cárdenas D, Ureña A. Effects of emotional regulation and impulsivity on sports performance: the mediating role of gender and competition level. Front Psychol 2023; 14:1164956. [PMID: 37469888 PMCID: PMC10352320 DOI: 10.3389/fpsyg.2023.1164956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/05/2023] [Indexed: 07/21/2023] Open
Abstract
Introduction This study aimed to study the relationships between emotional regulation and impulsivity on sports performance, according to the gender and competition level in national-level volleyball players. Methods In total, 77 players from the 2018-2019 top two Spanish divisions completed the ERQ (emotion regulation) and the UPPS-P (impulsivity). Statistics (serve, reception, and attack) were retrieved from the Spanish Volleyball Federation. A Mann-Whitney test was conducted to determine differences between gender and competition level in impulsivity and emotion regulation. A Kruskal-Wallis test (Mann-Whitney post-hoc) was carried out for playing positions analysis. Spearman's correlation was performed between the performance and the variables of impulsivity and emotional regulation. Results The results obtained, with differences according to playing position, gender, and competition level, show that players differ in certain psychological aspects that might influence how they approach their game. Discussion The results point in a promising direction: the sports practice analyzed can serve as a regulation context, for both the emotional response and the level of impulsivity of the players. The importance of these results for future research on this topic is discussed.
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Affiliation(s)
| | - Iker Madinabeitia
- Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Ricardo de la Vega
- Department of Physical Education, Sport and Human Movement, Autonomous University of Madrid, Madrid, Spain
| | - David Cárdenas
- Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Aurelio Ureña
- Department of Physical Education and Sport, University of Granada, Granada, Spain
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Pichler EM, Ewers S, Ajdacic-Gross V, Deutschmann M, Exner J, Kawohl W, Seifritz E, Claussen MC. Athletes are not at greater risk for death by suicide: A review. Scand J Med Sci Sports 2023; 33:569-585. [PMID: 36648386 DOI: 10.1111/sms.14316] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 11/21/2022] [Accepted: 01/05/2023] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Suicide represents a major mental and public health issue. Elite athletes share certain individual and environmental characteristics that may increase their risk for mental illnesses, ultimately leading to suicide. This notion conflicts with the general perception of athletes, being the healthiest representatives of society. METHODS A comprehensive literature search was carried out through PubMed and Embase databases for relevant publications. RESULTS Recent calls for investigating suicidality among athletes resulted in a considerable amount of literature providing some evidence regarding lower rates of suicide among professional and high-performance athletes as well as similar incidence and prevalence of mental conditions, which are known as risk factors for suicide. Nevertheless, special attention is required in this population as predisposing and precipitating factors might differ from classical features of suicidality in the general population. Sports physicians, sports psychiatrists, and other mental health professionals in elite sports should be aware of early signs of affective disorders, risk of recreational drug abuse, misuse of performance-enhancing medications, sport-specific environmental stressors, serious physical injuries, and presence of physical or mental illness, all of which may increase suicidality. Traumatic brain injury (TBI) is with suicide with higher severity correlated with increased risk. Compared to active athletes, former athletes may have higher rates of suicide due to common life stressors occurring after sports retirement. CONCLUSIONS The findings suggest a multidisciplinary approach to suicidality in elite athletes, the main goal of which should be the reduction of suicide-related morbidity and mortality. Further research is required to clarify the existing gaps in the current knowledge of the issue. While having lower rates of suicide, athletes share some similar (affective disorders, drug abuse, mental and physical illness) and unique factors (misuse of performance-enhancing substances, sports-related stressors, sports injuries, TBI) putting them at risk of suicide during active career and retirement.
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Affiliation(s)
- Eva-Maria Pichler
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland
| | - Simon Ewers
- Klinikum Fünfseenland, Fachklinik für Psychiatrie und Psychotherapie, Wallerfangen, Germany
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Markus Deutschmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Jan Exner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Wolfram Kawohl
- Department of Psychiatry and Psychotherapy, Psychiatric Services Aargau, Windisch, Switzerland.,Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.,Clienia Schlössli AG, Oetwil am See, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Malte Christian Claussen
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland.,Private Clinic Wyss AG, Münchenbuchsee, Switzerland.,Psychiatric Services Grisons, Chur, Switzerland
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Effects of Impulsivity on Competitive Anxiety in Female Athletes: The Mediating Role of Mindfulness Trait. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063223. [PMID: 35328913 PMCID: PMC8951821 DOI: 10.3390/ijerph19063223] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/21/2022] [Accepted: 03/06/2022] [Indexed: 02/04/2023]
Abstract
It has been demonstrated that athletes in competitive sports suffer from high levels of competitive anxiety, especially in the case of females. In this sense, it is necessary to identify possible risk and protective factors of those athletes in this collective who suffer from this type of anxiety. However, few studies analyze the relationship between Physical Activity (PA) and anxiety, identifying the possible mediation effect of trait variables such as impulsivity and mindfulness in female athletes. Hence, the aims of this study were: to determine differences between PA levels with anxiety, mindfulness, and impulsiveness; to identify the predictive value of sociodemographic factors and physical activity, impulsivity, and mindfulness on anxiety factors; and to analyze the possible mediating effects of mindfulness on the relationship between impulsivity and anxiety. A total of 242 female athletes underwent an assessment of physical activity, anxiety, mindfulness traits, and impulsivity using validated questionnaires. Data were analyzed according to (1) individual or collective sport, and (2) PA levels according to energy expended (METs min/day). Participants were grouped by light, moderate, and vigorous PA levels. There were 30.5% elite athletes and 73.2% collective sports athletes. Mean age was 22.1 years and mean light, moderate, and vigorous PA were 86.1 ± 136.2, 114.4 ± 159.8, and 370.1 ± 336.3 METs min/day, respectively. Those athletes performing vigorous PA exhibited lower levels of impulsiveness and higher mindfulness traits. As expected, the mindfulness trait was a mediating factor in the relationship between impulsiveness and each factor of competitive anxiety (cognitive, somatic, and self-efficacy). Female athletes could suffer competitive anxiety, especially those who present higher levels of impulsivity. However, higher levels of mindfulness traits seem to be a protective factor in the effects of impulsivity on anxiety in this population and have demonstrated to be significant mediators in this association. Further studies are needed with other female athletes to replicate these results and to determine the specific protective mechanisms of mindfulness traits in preventing competitive anxiety.
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A Feasibility Study of the Usefulness of the TEMPS-A Scale in Assessing Affective Temperament in Athletes. Medicina (B Aires) 2022; 58:medicina58020195. [PMID: 35208519 PMCID: PMC8876331 DOI: 10.3390/medicina58020195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 01/24/2022] [Indexed: 11/17/2022] Open
Abstract
Background and objectives: Current studies show an important role of affective temperament in sport performance. The aim of this study was to assess the feasibility of the use of the TEMPS-A scale, by using it to examine five dimensions of affective temperament in three groups of athletes. We hypothesized that temperament may be a predisposing factor to the level of commitment and type of training. Materials and methods: The study group (N:71, 33 female) consisted of professional canoeists (N:25, aged 18–30), sports pilots (N:21, aged 19–57) and non-professionals regularly performing aerobic exercises (N:25, aged 23–33). The Affective Temperament of Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A) was used to evaluate affective temperament dimensions. Statistical analysis was performed using non-parametric tests. Results: The TEMPS_A scale shows good internal consistency; a hyperthymic temperament was associated with different factors compared to other temperament traits. The most prevalent trait in the study group was hyperthymic temperament. The study group scored higher on hyperthymic and lower on depressive and anxious temperaments when compared with the general population. Canoeists scored higher on cyclothymic temperament compared with non-professional athletes and on cyclothymic and irritable dimensions in comparison with pilots. Pilots obtained significantly lower scores on irritable and anxious temperaments than non-professional athletes. Females scored higher on both hyperthymic and irritable dimensions. No significant differences were found in respect of depressive, cyclothymic and anxious traits. Age was negatively correlated with cyclothymic and irritable temperament scores. Conclusions: TEMPS-A scale is a useful tool for assessing affective temperament in athletes. The results suggest that affective temperament may be a factor influencing physical activity engagement. Different types of activities may be connected with different temperament dimensions. Younger athletes present a higher tendency to mood lability and sensitivity to environmental factors. However, further research is needed, involving larger numbers of subjects.
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Tingaz EO, Ekiz MA, Çakmak S. Examination of mindfulness and impulsiveness in university student-athletes in terms of sports injury development history. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01024-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-020-00259-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractSuicidal behavior (SB) is a major problem in patients with substance use disorders (SUDs). However, little is known about specific SB risk factors in this population, and pathogenetic hypotheses are difficult to disentangle. This study investigated some SB and SUD-related endophenotypes, such as impulsivity, aggression, trait anger, and risk-taking behaviors (RTBs), in forty-eight patients with SUDs in relation to lifetime history of suicide attempts (SAs). Disorders related to alcohol, cannabis, cocaine, opiates, and hallucinogenic drugs were included. Lifetime SAs was significantly associated with both higher impulsivity and higher aggression, but not with trait anger. A higher number of RTBs were associated with lifetime SAs and higher impulsivity, but not with aggression and trait anger. Assessing these endophenotypes could refine clinical SB risk evaluation in SUDs patients by detecting higher-risk subgroups. An important limitation of this study is exiguity of its sample size. Its primary contribution is inclusion of all SUD types.
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Currie A, Gorczynski P, Rice SM, Purcell R, McAllister-Williams RH, Hitchcock ME, Hainline B, Reardon CL. Bipolar and psychotic disorders in elite athletes: a narrative review. Br J Sports Med 2019; 53:746-753. [DOI: 10.1136/bjsports-2019-100685] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 01/08/2023]
Abstract
Bipolar and psychotic disorders are relatively common and likely to have a significant impact on quality of life and functioning which, in the context of elite sport, includes a potential negative impact on sporting performance. For this narrative review article, the literature on bipolar and psychotic disorders in elite athletes was comprehensively searched, and little empirical research was found. A diagnosis of bipolar or psychotic disorders may be challenging in elite athletes because of complicating factors related to the modifying role of exercise and potential precipitating impact of substance use. Medications used to treat bipolar and psychotic disorders may have side effects particularly problematic for elite athletes. Future research should be tailored to the specific characteristics and needs of elite athletes and to the sporting context in which the disorders may arise. Specifically, further research is needed on the prevalence and incidence of these conditions in elite athletes and the impact of both the disorders and their treatments on sporting performance.
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Chrobak AA, Siwek M, Dudek D, Rybakowski JK. Content overlap analysis of 64 (hypo)mania symptoms among seven common rating scales. Int J Methods Psychiatr Res 2018; 27:e1737. [PMID: 30058102 PMCID: PMC6877160 DOI: 10.1002/mpr.1737] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 05/31/2018] [Accepted: 06/26/2018] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES Fried () quantified the overlap of items among seven widely used depression rating scales. The analysis revealed substantial heterogeneity of the depressive syndromes and a low overlap among the scales. To our best knowledge, there are no studies evaluating the content overlap of (hypo)mania scales. The goal of our study, therefore, is to quantify the overlap of items among seven widely used (hypo)manic scales, implementing the methodology developed by Fried (). METHODS Seven commonly used (hypo)manic scales underwent content analysis. Symptom overlap was evaluated with the use of the Jaccard index (0 = no overlap, 1 = full overlap). In case of every scale, rates of idiosyncratic symptoms and rates of specific versus compound symptoms were calculated. RESULTS The seven scales gathered 64 hypo(manic) symptoms. The mean overlap among all of the instruments was low (0.35), the mean overlap of each scale with all others ranged from 0.29 to 0.48, and the overlap among individual scales ranged from 0.20 to 0.65. Thirty-six percent of symptoms appeared only on one scale. Only 6% of the symptoms appeared on all of the instruments. CONCLUSIONS We have shown that using (hypo)manic scales as interchangeable measurements may be problematic.
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Affiliation(s)
- Adrian A Chrobak
- Department of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Chair of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Dominika Dudek
- Department of Adult Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
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Chrobak AA, Tereszko A, Dembinska-Krajewska D, Arciszewska A, Dopierała E, Siwek M, Dudek D, Rybakowski JK. The role of affective temperaments assessed by the Temperament Evaluation of Memphis, Pisa and San Diego-Autoquestionnaire (TEMPS-A) in the relationship between morningness-eveningness and bipolarity. J Affect Disord 2018; 232:83-88. [PMID: 29477589 DOI: 10.1016/j.jad.2018.02.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 01/16/2018] [Accepted: 02/15/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Growing number of studies indicates a link between eveningness chronotype, affective temperaments and bipolarity, both in patients with mood disorders and in general population. Given these tripartite associations, we hypothesized that the effect of circadian preferences on the bipolarity may be mediated by the temperamental traits. METHODS The study included 1449 subjects (402 men and 1047 women). They all fulfilled a web-based questionnaire, consisting of the Composite Scale of Morningness (CSM), Mood Disorder Questionnaire (MDQ), Hypomania Checklist-32 (HCL-32) and the Temperament Evaluation of the Memphis, Pisa and San Diego-Autoquestionnaire (TEMPS-A). The role of temperamental traits in the relationship between morningness-eveningness and bipolarity was assessed using mediation analysis. RESULTS Morningness is correlated with lower bipolarity measured by the MDQ and HCL-32, and to lower scores of depressive, cyclothymic, irritable and anxious temperaments of the TEMPS-A. There is no significant association between morningness and hyperthymic traits. Cyclothymic and irritable traits are full mediators of the association between chronotype and bipolarity, influencing bipolarity independently from circadian preferences. Depressive and anxious traits are partial mediators of this association, increasing the effect of eveningness on bipolarity. LIMITATIONS The indirectness of the findings in the web-based study and disproportion of participants' gender. CONCLUSIONS Our study confirmed that eveningness is associated with bipolarity. In case of depressive and anxious temperaments, bipolarity is associated stronger with eveningness than with the TEMPS-A scores. On the other hand, cyclothymic and irritable temperaments were associated with bipolarity independently from circadian preferences.
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Affiliation(s)
- Adrian A Chrobak
- Department of Psychiatry, Jagiellonian University Medical College, Kopernika 21A, 31-501 Krakow, Poland.
| | - Anna Tereszko
- Jagiellonian University Medical College, Krakow, Poland
| | | | - Aleksandra Arciszewska
- Department of Affective Disorders, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Dopierała
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Marcin Siwek
- Department of Affective Disorders, Jagiellonian University Medical College, Krakow, Poland
| | - Dominika Dudek
- Department of Affective Disorders, Jagiellonian University Medical College, Krakow, Poland
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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