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Introduction The eating disorders (ET) seem more and more common. These disorders are multifactorial. Several risk factors have been studied in literature. However, the link with the temperament, biological basis of personality and depression are scarce. Aims The estimation of the prevalence of ET, cyclothymic temperament (CT) and depression among medical students and the assessment the relationship between these three parameters. Methods This is a descriptive transversal and analytical study involving one hundred and seven students from the Faculty of Medicine of Sfax. The study was conducted using the EAT (Eating Attitude Test 40) for the evaluation of ET, extract TEMPS -A (Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto – questionnaire) to evaluate the CT and Beck scale (BDI: Beck depression Inventory), allowing depression detection. Results The mean age was 21.08 years. Around two-thirds of the students were females, 60.7 %. The ET- prevalence was 13.1 %. Nearly half of the students (46.7%) were depressed at the time of the survey, five (4.7%) presented severe depression cases. The prevalence of CT was 44.9%. We found a significant correlation between the presence of CT and both ET and depression disorders according to both dimensional and categorical approaches. An association was found between depression and ET Conclusion In our population, the prevalence of depression and the ET is important. The CT was associated with these two disorders, which requires the multiplication of students surveyed, to know the prevalence of this disorder better and search for psychiatric comorbidities and risk factors. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to assess sociodemographic and clinical differences between inpatients with major mood disorders and the cyclothymic phenotype, and pure BDs or MDDs. Methods Participants were 281 adult inpatients consecutively admitted to the Department of Psychiatry of the Sant'Andrea University Hospital in Rome, Italy, between January 2008 and June 2010. The patients completed the Hamilton Scale for Depression, the Young Mania Rating Scale, the TEMPS-A, and the Beck Hopelessness Scale. Results 38.7% of the MDD patients and 48.3% of the BD patients satisfied criteria to be included in the cyclothymic groups. Above 92% of the patients with the cyclothymic phenotype reported suicidal ideation at the item#3 of the HAMD17. Furthermore, patients with the cyclothymic phenotype reported higher hopelessness than other patients. Conclusions Our results support the clinical usefulness of the concept of soft bipolar spectrum. Patients with the cyclothymic phenotype differ from pure MDD patients and BD patients for temperamental profile and clinical variables. [ABSTRACT FROM AUTHOR]

Disorders of the bipolar spectrum (e.g. cyclothymic disorder) and subthreshold manifestations of mood disorders (such as temperamental traits) have been suggested to influence the course of psychiatric diseases. Cyclothymic temperament (as described by Kraepelin and as measured by Akiskal's temperament scale, the TEMPS) has been suggested to be the most morbid and prodromal element in the pathogenic chain of personal disposition to behavioural and emotional problems. We studied the effects of affective temperaments on psychoactive substance use, on alcohol dependence and opioid dependence. In particular, we wanted to test the hypothesis whether cyclothymic temperament mediates a deleterious effect. 1380 inhabitants of residential student homes in Austria, 116 alcohol dependent patients at the Medical University of Vienna and 101 opioid dependent patients at the Oum El Nour rehabilitation center in Lebanon were investigated. Temperament was assessed using the briefTEMPS-M auto-questionnaire. In opioid dependence, subtypes were assessed according to the LAT interview (www.lat-online.at). In the college student group, cyclothymic (and irritable) temperament serves as predictor of self-reported nicotine dependence, alcohol abuse and cannabis use. In alcohol dependent patients, cyclothymic temperament influenced the age of onset of alcohol abuse and the age of onset of alcohol dependence. In the opioid dependence group, patients exhibiting symptoms of severe negative childhood development according to the LAT interview (e.g. prenatal trauma, cerebral trauma before the age of 14) showed the highest percentage of cyclothymic temperament. Our data show that cyclothymic temperament as measured by the briefTEMPS-M is an important negative pathoplastic factor for substance-related addictive disorders. [ABSTRACT FROM AUTHOR]

The appearance of bipolar affective disorder after stroke depends on the presence of two factors: a predisposing factor of either genetic loading or subcortical atrophy, and a lesion of specific corticolimbic pathways involving the right hemisphere. Whether cyclothymia and seasonal affective disorder further predispose to poststroke affective disorder is not clear. A case is described which highlights these issues. The aetiological factors, pathophysiology, and diagnosis are discussed. [ABSTRACT FROM AUTHOR]

The present study is examined the expression of affective temperaments in daily life using experience sampling methodology (ESM). 138 participants completed the TEMPS-A and were then signaled eight times daily for one week to complete questionnaires that assessed affect, cognition, behavior, sense of self, and social interaction. As expected, cyclothymic/irritable temperament was positively associated with negative affect, risky behavior, and restlessness, and was negatively associated with positive affect and preference to be with others in daily life. In contrast, hyperthymic temperament was associated with positive affect, fullness of thought, doing many and exciting things, grandiosity, and preference to be with others in daily life. Cross-level interactions indicated that cyclothymic/irritable temperament was associated with elevated stress reactivity in daily life. This was the first study to examine affective temperaments in daily life. The findings offer further validation of the TEMPS-A, as well as the maladaptive nature of the cyclothymic/irritable temperament. [ABSTRACT FROM AUTHOR]

Information about the 16th Annual Conference of the International Society for Bipolar Disorders (ISBD) in Seoul, Korea is presented. During the event, attendees took part in different programs and activities related to diagnosis and treatment of bipolar disease of both children and adult. Moreover, it states that the event is aimed at promoting bipolar disorders in the Asian region.

Introduction: Premenstrual dysphoric disorder is a premenstrual syndrome comprising physical and psychic symptoms. Bipolar disorders, particularly “soft” forms, share symptoms such as depressive mood, irritability or mood reactivity with premenstrual dysphoric disorder, posing challenges on differential diagnosis. In the present work a case of a woman suffering from cyclothymia is reported, with mood episodes confined in the luteal phase of the menstrual cycle. Methods: Case Report. Results: A 42-year-old married Caucasian woman is presented, suffering from mood disorder episodes lasting for 10-12 days each, during the luteal phase of the menstrual cycle, and remitting after the beginning of her menses. The mood episodes occurred since the age of 20, in almost every menstrual cycle. The patient described hypomanic symptoms during the first 4-5 days of the luteal phase, reporting irritable mood, pressured speech, increased libido as well as vividness of her perceptions and excessive goal-directed activity. The hypomanic symptoms were followed by irritable and depressive mood, fatigue, hypersomnia, tearfulness, decreased self-esteem and pessimism, lasting for another 6-7 days. The patient also reported migraine and binge-eating episodes during each depressive phase. A full range of examinations, including blood and hormonal tests, yielded normal results. Lamotrigine was titrated at 200mg/day, with subsequent amelioration of symptoms. Conclusions: The exact relationship between premenstrual dysphoric disorder and other disturbances, which either coexist, or deteriorate premenstrually, or even synchronize with the menstrual cycle, has not been elucidated yet. Studies aiming at a better understanding of this relationship could aid at accurate diagnosis and treatment. [Copyright &y& Elsevier]

Introduction: Psychosocial stressors are found in 40 to 80% of patients with psoriasis. The inability to cope with a stressful situation can induce a flare up of psoriasis. Several factors modulate our adaptive response to stress such as affective temperament (AT). Objectives: The objective of this study is to determine the dominant AT in patients with psoriasis and the correlation between AT and clinical features of the disease. Methods: It was a descriptive cross-sectional study. A total of sixty five subjects and two examiners were recruited. The evaluation of temperament was made thanks the Tunisian version of TEMPS-A. Results: Hyperthymic temperament (HT) was the dominant temperament in patients with psoriasis (70%). Patients with poor response to treatment had a higher prevalence of cyclothymic (CT), depressive (DT), irritable (IT) and anxious (AT) temperament. The prevalence of CT (p=0.039), DT and AT (p=0.032) was higher in patient with joint pain and pruritus. The stressful situations induce more flare up of psoriasis in patient with AT (p=0.006) and DT (p=0.06). A patient with HT reported minimal discomfort, the patient with IT, CT, DT and AT had daily to major discomfort. Conclusion: Patients with psoriasis have the same dominant temperament than general population. However, the patients with AT, CT, DT and IT have more poor response to treatment and more functionally disabling symptoms (pruritus, joint pain). The impact on quality of life and expressed discomfort would be greater. [Copyright &y& Elsevier]

Abstract: Background: Temperament is the stable core of personality and it may represent the underlying continuity between how the person typically is (trait) and how the person temporarily changes (state). Comorbid depression in patients with Type 2 diabetes is important because of the negative consequences on the prognosis of diabetes. Little research has explored the relationships between temperament, depression and type 2 diabetes. The aims of the present paper are first to describe current research that has examined the relationship between temperament, diabetes and depression, and second to make recommendations for future research. Methods: Literature search from Medline and references in published papers. Results: Current research has described the relationship of temperament with cyclothymia, bipolar disorder, mood instability and suicidality. Studies on the relationship between temperament and depressive disorders are scarce. Nevertheless, there is likely a continuum between depressive temperament and related personality traits and subthreshold and clinical depressive states and disorders and diabetes outcomes. Limitations: The greatest limitation concerns the scarcity of papers on this issue. There are also methodological limitations in accurately assessing depressive temperament versus current depressive disorders and residual symptoms from these disorders. Conclusion: Depressive temperament may be a promising construct to understand better the interplay between depression and diabetes. [Copyright &y& Elsevier]

In this text we are showing a patient with a very complex “life story”, dominated by extreme difficulties in the developmental period, strong family complications and personal problems, which probably significantly influenced the development of later psychological difficulties. The clinical picture is dominated by symptoms of borderline personality disorder (BPD), but also shows symptoms that would fall under bipolar affective disorder (BD) and cyclothymia. During the screening of the patient and during treatment, we tried to resolve the resulting diagnostic dilemma. Some authors even believe that BPD falls into the BD spectrum of disorders, whereas others insist on the viewpoint that it is a comorbidity of two separate entities. For clinical practice, the important fact is that BD and BPD multiplies the risk of suicidal patients, which requires prompt and adequate combined treatment. The primary psychopharmacological methods are used for BD, while primary psychotherapeutic treatment is used for BPD. In this study, we’ll in detail deal with the comorbidity of BD and BPD, which are becoming more frequent psychiatric comorbidities, while emphasizing individual and integrative psychopharmacological therapies as the only approach that can act on several factors and ensure the best possible treatment outcome. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to assess sociodemographic and clinical differences between BD patients, pure MDD patients, and MDD patients with cyclothymic temperament (MDD-CYC). Methods: Participants were 281 adult inpatients (134 men and 147 women) consecutively admitted to the Department of Psychiatry of the Sant''Andrea University Hospital in Rome, Italy, between January 2008 and June 2010. The patients completed the Hamilton Scale for Depression (HAMD17), the Young Mania Rating Scale, the TEMPS-A (Temperament Evaluation of the Memphis, Pisa, Paris and San Diego - Autoquestionnaire) and the Beck Hopelessness Scale. Results: 38.7% of the MDD patients met criteria to be included in the MDD-CYC group. Above 93% of the MDD-CYC reported suicidal ideation (27.6% suicide attempts) at the item 3 of the HAMD17.Furthermore, MDD-CYC patients reported higher hopelessness compered to other patients. Limitations: Our results are potentially limited by the small number of MDD-CYC patients included in the sample. Conclusions: Our results support the clinical usefulness of the concept of soft bipolar spectrum. Patients with unipolar depression and cyclothymic temperament differ from pure MDD patients and BD patients in terms of temperamental profile and clinical variables. [Copyright &y& Elsevier]

Abstract: Affective temperament and psychopathological traits such as separation anxiety (SA) and interpersonal sensitivity (IPS) are supposed to impact on the clinical manifestation and on the course of Bipolar Disorder (BD); in the present study we investigated their influence on the definition of BD subtypes. Method:: Among 106 BD-I patients with DSM-IV depressive, manic or mixed episode included in a multi-centric Italian study and treated according to the routine clinical practice, 89 (84.0%) were in remission after a follow-up period ranging from 3 to 6months (Clinical Global Impression-BP [CGI-BP] <2). Remitting patients underwent a comprehensive evaluation including self-report questionnaires such as the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A) scale, Separation Anxiety Symptom Inventory (SASI), Interpersonal Sensitivity Measure (IPSM) and the Semi-structured interview for Mood Disorder (SIMD-R) administered by experienced clinicians. Correlation and factorial analyses were conducted on temperamental and psychopathological measures. Comparative analyses were conducted on different temperamental subtypes based on the TEMPS-A, SASI and IPSM profile. Results:: Depressive, cyclothymic and irritable TEMPS-A score and SASI and IPSM total scores were positively and statistically correlated with each other. On the contrary, hyperthymic temperament score was negatively correlated with depressive temperament and not significantly correlated with the other temperamental and psychopathological dimensions. The factorial analysis of the TEMPS-A subscales and SASI and IPSM total scores allowed the extraction of 2 factors: the cyclothymic-sensitive (explaining 46% of the variance) that included, as positive components, depressive, cyclothymic, irritable temperaments and SASI and IPSM scores; the hyperthymic (explaining the 19% of the variance) included hyperthymic temperament as the only positive component and depressive temperament and IPSM, as negative components. Dominant cyclothymic-sensitive patients (n =49) were more frequently females and reported higher number of depressive, hypomanic and suicide attempts when compared to the dominant hyperthymic patients (n =40). On the contrary, these latter showed a higher number of manic episodes and hospitalizations than cyclothymic-sensitive patients. The rates of first-degree family history for both mood and anxiety disorders were higher in cyclothymic-sensitive than in hyperthymic patients. Cyclothymic sensitive patients also reported more axis I lifetime co-morbidities with Panic Disorder/Agoraphobia and Social Anxiety Disorder in comparison with hyperthymics. As concerns axis II co-morbidity the cyclothymic-sensitive patients met more frequently DSM-IV criteria 1, 5 and 7 for borderline personality disorder than the hyperthymics. On the contrary, antisocial personality disorder was more represented among hyperthymic than cyclothymic patients, in particular for DSM-IV criteria 1 and 6. Limitation:: No blind evaluation and uncertain validity of personality inventory. Conclusion:: Our results support the view that affective temperaments influence the clinical features of BD in terms of both clinical and course characteristics, family history and axis I and II co-morbidities. Hypothetical temperamental subtypes as measured by TEMPS-A presented important interrelationships that permit to reliably isolate two fundamental temperamental disposition: the first characterized by rapid fluctuations of mood and emotional instability, and the second by hyperactivity, high level of energy and emotional intensity. Dominant cyclothymic and hyperthymic bipolar I patients reported important differences in terms of gender distribution, number and polarity of previous episodes, hospitalizations, suicidality, rates of co-morbid anxiety and personality traits and disorders. Our data are consistent with the hypothesis that affective temperaments, and in particular cyclothymia, could be utilized as quantitative, intermediate phenotypes in order to identify BD susceptibility genes. [Copyright &y& Elsevier]

It is estimated that only one-third of the people with bipolar disorder are correctly diagnosed, and even fewer are receiving appropriate treatment. This information is of concern, particularly in light of emerging data reflecting the potential negative consequences of failed or delayed diagnosis and lack of focused treatment. The article attempts to illuminate this complex disorder by describing the bipolar spectrum through a review of the criteria for diagnosis, aswell as practical advice on improving the detection of the disorder. Treatment options for bipolar disorder, with a focus on the latest pharmacological evidence base, as well as clinical recommendations regarding the safe and effective use of mood stabilizers and antidepressants are presented. [ABSTRACT FROM PUBLISHER]