Affective temperaments in patients with mood and anxiety disorders

Objective Temperament conventionally refers to stable behavioral and emotional reactions that appear early in life and are influenced, in part, by genetic constitution. Although most personality constructs have been standardized in population studies, cyclothymic, depressive, irritable and hyperthymic temperaments, putatively linked to mood disorders, have been classically derived from clinical observations. Few studies have compared temperamental traits in anxiety and mood disorders even though some authors have suggested a clinical and neurobiological continuum between anxiety and mood disorders. Therefore, the aim of the study was to evaluate temperamental traits in subjects with DSM-IV diagnosis of mood and anxiety disorders and their correlation with the psychopathological dimensions. Methods A total of 60 consecutive clinically stabilized outpatients referring to the Mental Health Centre of L'Aquila and to the "Casa di Cura Villa Serena" of Pescara were evaluated. All subjects were submitted to a clinical evaluation following DSM-IV criteria. Of these subjects, 33 received a diagnosis of anxiety disorders, while 27 subjects received a diagnosis of mood disorders. The brief version of Temperament Evaluation of Memphis, Pisa, Paris and San Diego (briefTEMPS-M) and Symptom Checklist-90 (SCL-90) were used to assess temperamental traits and psychopathologic dimensions, respectively. The TEMPS-M is a 35 item self-reported for the study of five temperamental subscales, i.e., depressive, hyperthymic, clyclothymic, irritable and anxious. The SCL-90 is a 90 item self-reported of subjects' symptoms and psychopathologic features on 9 subscales: paranoid ideation, interpersonal sensitivity, hostility, psychoticism, phobic, anxiety, somatization, obsessive-compulsive, and general symptoms. Results No significant differences in the TEMPS-M (Table IV) or in the SCL-90 (Table II) mean scores were observed between subjects with Anxiety Disorders and those with Mood Disorders. With the exception of irritable temperament subscale, significant differences were observed in the TEMPS-M total and subscales means score between clinical and literature samples (Table III). While several SCL-90 scores do correlate with depressive, cyclothymic, irritable and anxious temperaments, no correlations were seen vs. hyperthymic (Table V). Conclusions Our data may represent an indirect indicator of possible common between the two different disorders, differing in categorical evaluation but joined through temperamental dimensions. Furthermore, hyperthymic temperament appears "independent" from the other temperaments. Therefore, the hyperthymic type could stand apart from other affective temperaments as possibly "protective" against affective breakdowns. Evaluation of affective temperaments seems to add considerable clinical information to psychopathological and diagnostic descriptions. Moreover, temperament assessment could be important for choice of treatment and formulation of prognosis.