1
|
Iorio C, Barlattani T, Pacitti F, Iorio P, Pompili A. The role of affective temperaments as a factor of vulnerability to seasonal affective disorder. J Affect Disord 2024; 364:96-103. [PMID: 39142572 DOI: 10.1016/j.jad.2024.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 07/19/2024] [Accepted: 08/11/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Growing evidence suggests the relevance of affective temperaments in the development of mood disorders. This study aims to assess their potential role as a vulnerability factor for seasonal affective disorder (SAD) and subsyndromal SAD (S-SAD) in a sample of young individuals without a history of clinical diagnosis. METHODS Eight hundred and forty-six university students were enrolled in a cross-sectional study. Participants were evaluated for exclusion and inclusion criteria and divided into Control, S-SAD, and SAD groups. They filled out two self-administered questionnaires to assess the degree of seasonality problems and the predominant type of affective temperaments, the Seasonal Pattern Assessment Questionnaire (SPAQ), and the Temperament Evaluation Instrument of Memphis, Pisa, Paris, and San Diego-Auto-questionnaire version scale (briefTEMPS-M version). We conducted a multinomial logistic regression model to explore the relationship between affective temperaments and seasonality. RESULTS Our results evidenced that cyclothymic [χ2 (2) = 33.486, p < 0.001] and anxious [χ2 (2) = 86.991, p < 0.001] temperaments were significant predictors in the model, suggesting that individuals with cyclothymic and anxious temperaments are at increased risk of developing SAD, due to heightened seasonal changes in mood and behavior. In contrast, people with hyperthymic temperament appear less susceptible to experiencing seasonal problems. LIMITATIONS The homogeneity of the sample; only retrospective self-reported data were considered; measures of temperament and seasonality were simultaneously assessed. CONCLUSIONS Understanding which affective temperaments may constitute a potential predisposing factor for vulnerability to seasonal changes can aid in better assessing SAD and predicting its outcome.
Collapse
Affiliation(s)
- Carla Iorio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Tommaso Barlattani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Francesca Pacitti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Paola Iorio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Assunta Pompili
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| |
Collapse
|
2
|
Favaretto E, Bedani F, Brancati GE, De Berardis D, Giovannini S, Scarcella L, Martiadis V, Martini A, Pampaloni I, Perugi G, Pessina E, Raffone F, Ressico F, Cattaneo CI. Synthesising 30 years of clinical experience and scientific insight on affective temperaments in psychiatric disorders: State of the art. J Affect Disord 2024; 362:406-415. [PMID: 38972642 DOI: 10.1016/j.jad.2024.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/17/2024] [Accepted: 07/04/2024] [Indexed: 07/09/2024]
Abstract
The concept of affective temperament has been extensively discussed throughout the history of psychopathology and represents a cornerstone in the study of mood disorders. This review aims to trace the evolution of the concept of affective temperaments (ATs) from Kraepelin's seminal work to the present day. In the 1980s, Akiskal redefined Kraepelin's concept of affective temperaments (ATs) by integrating the five recognized ATs into the broader framework of the soft bipolar spectrum. This conceptualization viewed ATs as non-pathological predispositions underlying psychiatric disorders, particularly mood disorders. Epidemiological and clinical studies have validated the existence of the five ATs. Furthermore, evidence suggests that ATs may serve as precursors to various psychiatric disorders and influence clinical dimensions such as disease course, psychopathology, and treatment adherence. Additionally, ATs appear to play a significant role in moderating phenomena such as suicide risk and stress coping. Incorporating an evaluation of temperamental bases of disorders into the multidimensional psychiatric diagnostic process could enhance treatment optimization and prognosis estimation.
Collapse
Affiliation(s)
- E Favaretto
- Department of Addiction, South Tyrol Health Care, Bressanone, Italy.
| | - F Bedani
- Mercy University Hospital, Cork, IRELAND
| | | | - D De Berardis
- Department of Psychiatry, Azienda Sanitaria Locale 4, Teramo, ITALY.
| | - S Giovannini
- Department of Addiction, South Tyrol Health Care, Bressanone, Italy
| | - L Scarcella
- Department of Psychiatry, South Tyrol Health Care, Bressanone, Italy.
| | - V Martiadis
- Department of Mental Health, Asl Napoli 1 Centro, Naples, Italy
| | - A Martini
- Department of Mental Health, ASL CN2 Alba - Bra, Italy
| | - I Pampaloni
- National OCD and BDD Unit, South West London and St Georges NHS Trust, London, United Kingdom.
| | - G Perugi
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy.
| | - E Pessina
- Department of Mental Health, ASL CN2 Alba - Bra, Italy
| | - F Raffone
- Department of Mental Health, Asl Napoli 1 Centro, Naples, Italy
| | - F Ressico
- Outpatient Unit Department of Mental Health Novara, Borgomanero, Italy
| | | |
Collapse
|
3
|
Szabo G, Szigeti F J, Sipos M, Varbiro S, Gonda X. Adherence to dietary recommendations mediates the effect of affective temperaments on infertility treatment outcomes. Sci Rep 2024; 14:12544. [PMID: 38822094 PMCID: PMC11143238 DOI: 10.1038/s41598-024-63343-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
Affective temperaments have been shown to robustly affect infertility treatment success. However, identification of possible mediating factors through which they exert their influence is still lacking. A growing number of results suggest that adherence to recommended treatments may be such a mediator, on the one hand, because affective temperaments are known to influence adherence and, on the other hand, because non-adherence negatively influences the treatment outcome. Recommended treatment of infertility involves, beyond medications, dietary and lifestyle changes. The aim of this retrospective cohort study was to evaluate whether adherence to physician-prescribed diet and physical activity recommendations mediates the effect of affective temperaments on infertility treatment outcomes. Among 308 women who underwent infertility treatment in an Assisted Reproduction Center, affective temperaments, adherence to diet, adherence to physical exercise, and infertility treatment success (clinical pregnancy) were assessed besides detailed medical history and demographic parameters. Associations between affective temperaments, adherence to diet and recommended physical activity, and assisted reproduction outcomes were analyzed using generalized linear models and causal mediation analysis. Adherence to physical activity didn't have an effect, but diet adherence increased the odds of infertility treatment success by 130% suggesting its role as a potential mediator. Based on causal mediation analysis, higher depressive and anxious temperament scores were directly associated with 63% and 45% lower odds of achieving clinical pregnancy, respectively, with effects not mediated by diet adherence. Higher irritable temperament scores indirectly decreased the odds of achieving clinical pregnancy by 14%, mediated by diet adherence; while higher cyclothymic temperament scores decreased the odds of achieving clinical pregnancy both directly by 51% and indirectly, mediated by diet adherence by 11%. Our results suggest that diet adherence mediates the mechanism by which irritable and cyclothymic affective temperaments influence IVF treatment success. Since adherence is a modifiable risk factor of infertility treatment success, screening for affective temperaments may help to identify potentially high-risk non-adherent patient groups and offer patient-tailored treatment, which may help increase the chances of a successful pregnancy and live birth in women undergoing IVF treatment.
Collapse
Affiliation(s)
- Georgina Szabo
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Judit Szigeti F
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Miklos Sipos
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Szabolcs Varbiro
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Gyulai Pal utca 2, Budapest, 1085, Hungary.
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Nagyvárad tér 4., Budapest, 1085, Hungary.
| |
Collapse
|
4
|
Fiorini G, Pellegrini G, Franchi M, Rigamonti AE, Marazzi N, Sartorio A, Corrao G, Cella SG. Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study. BMJ Open 2024; 14:e078431. [PMID: 38724060 PMCID: PMC11086564 DOI: 10.1136/bmjopen-2023-078431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 04/19/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES To investigate the time course of medication adherence and some of the factors involved in this process in undocumented migrants with chronic diseases. DESIGN Retrospective cohort study. SETTING A big non-governmental organisation in Milano, Italy, giving medical assistance to undocumented migrants. PARTICIPANTS 1918 patients, 998 females and 920 males, with at least one chronic condition (diabetes, cardiovascular diseases (CVDs), mental health disorders) seen over a period of 10 years (2011-2020). Their mean age was 49.2±13 years. RESULTS Adherence to medications decreased over 1 year in all patients. This was more evident during the first 2 months of treatment. Patients on only one medication were less adherent than those on more than one medication; at 6 months the percentage of patients with high adherence was 33% vs 57% (p<0.0001) for diabetes, 15% vs 46% (p<0.0001) for mental disorders and 35% vs 59% (p<0.0001) for CVDs. Patients with mental disorders had the lowest adherence: 25% at 6 months and 3% at 1 year. Mental disorders, when present as comorbidities, greatly reduced the probability of being highly adherent: risk ratio (RR) 0.72 (95% CI 0.57 to 0.91; p=0.006) at 3 months, RR 0.77, (95% CI 0.59 to 1.01; p=0.06) at 6 months, RR 0.35 (95% CI 0.13 to 0.94; p=0.04) at 1 year. This was especially evident for patients with CVDs, whose percentage of high adherents decreased to 30% (p=0.0008) at 6 months and to 3% (p=0.01) at 1 year. We also noted that highly adherent patients usually were those most frequently seen by a doctor. CONCLUSIONS Interventions to increase medication adherence of undocumented migrants with chronic diseases are necessary, particularly in the first 2 months after beginning treatment. These should be aimed at people-centred care and include more outpatient consultations. Educational interventions should especially be taken into consideration for patients on monotherapy.
Collapse
Affiliation(s)
- Gianfrancesco Fiorini
- Istituti Clinici Zucchi Spa, Monza, Italy
- Università degli Studi di Milano, Milano, Italy
| | | | | | | | - Nicoletta Marazzi
- Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy
| | | | | |
Collapse
|
5
|
Szabo G, Szigeti F J, Sipos M, Varbiro S, Gonda X. Affective temperaments show stronger association with infertility treatment success compared to somatic factors, highlighting the role of personality focused interventions. Sci Rep 2023; 13:21956. [PMID: 38081851 PMCID: PMC10713532 DOI: 10.1038/s41598-023-47969-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/20/2023] [Indexed: 12/18/2023] Open
Abstract
Infertility has a multifactorial background, where, besides somatic factors, psychological contributors also play a role in development and outcome. While affective temperaments have been associated with development, course, and outcome as well as treatment success in various somatic conditions, their association with infertility and its treatment has not been investigated so far. The purpose of our retrospective cohort study was to evaluate the influence of affective temperaments on fertility treatment outcomes. Among 578 women who underwent infertility treatment in an Assisted Reproduction Centre in Budapest, Hungary, treatment success, detailed medical history, and demographic parameters were recorded, and the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) was administered. Possible predictors of assisted reproduction outcome were analyzed using multivariate logistic regression models, followed by a receiver operating curve (ROC) analysis in order to define ideal affective temperament cut-off values for clinical applicability. Aside from age, BMI, and previous miscarriage, cyclothymic scores > 4 (OR = 0.51 CI 0.35-0.74, p < 0.001), depressive scores > 9 (OR = 0.59 CI 0.4-0.87, p = 0.009) and anxious scores > 9 (OR = 0.45 CI 0.31-0.66, p < 0.001) significantly decreased the odds of clinical pregnancy by 49%, 41% and 55%, respectively. Irritable and hyperthymic temperaments, as well as other somatic and socio-economic factors had no effect on infertility treatment outcomes. The results suggest that affective temperaments may be related to the outcome of infertility treatments. Thus, screening for affective temperaments may help identify high-risk patient groups and offer patient-tailored treatment, which may increase the chances of a successful pregnancy and live birth for women undergoing IVF treatment.
Collapse
Affiliation(s)
- Georgina Szabo
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Judit Szigeti F
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary
| | - Miklos Sipos
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Szabolcs Varbiro
- Department of Obstetrics and Gynecology, Semmelweis University, Budapest, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Gyulai Pál Street 2, 1085, Budapest, Hungary.
| |
Collapse
|