Suicide is a leading cause of death and suffering worldwide, mental disorder being a major risk factor for it. Recent data suggest that the underlying temperament may be more important as a risk factor than the exact psychiatric diagnosis.

A cross-sectional non-interventional study of 79 patients with DSM-IV major depressive episode (58 females, 21 males; aged 19–66 years), evaluated by M.I.N.I. Their temperament was assessed through the self-rated TEMPS-A. Patients were distributed into four groups: 1) fMDE - first major depressive episode (n=16); 2) RMD - recurrent major depression: at least 5 years duration of illness, no previous (hypo)manic/mixed episodes, and no first-degree relatives with bipolar disorder (n=23); 3) BDI - MDE with at least one previous manic episode (n=19); 4) BDII – two or more MDE with at least one previous hypomanic episode (n=21).

No significant intergroup differences in the level of suicidal risk measured by the M.I.N.I. No gender difference in the M.I.N.I. risk for suicide, however, female gender was associated with a higher number of previous suicide attempts (p=0.001). The fMDE group had higher mean score for hyperthymic temperament, and the RMD group had higher mean score for anxious temperament. After controlling for the diagnosis and gender, a significant positive correlation was found between level of suicidal risk and mean score for depressive, cyclothymic, and irritable temperament (p<0.05), while the correlation was negative for hyperthymic temperament (p=0.001).

We suggest that hyperthymic temperament is a protective factor against suicide in patients with affective disorders.