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Temperament as a basic element of bipolar spectrum and subthreshold manifestations

Published online by Cambridge University Press:  16 April 2020

D. Harnic
Affiliation:
Bipolar Disorders Unit, Day Hospital of Psychiatry, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
A. Koukopoulos
Affiliation:
Centro Lucio Bini, Rome, Italy
M. Mazza
Affiliation:
Bipolar Disorders Unit, Day Hospital of Psychiatry, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
P. Bria
Affiliation:
Bipolar Disorders Unit, Day Hospital of Psychiatry, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy

Abstract

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Objectives

Temperament represents one of the basic elements of bipolar spectrum.

Methods

A systematic search was undertaken in MEDLINE (from 1977 to 2007) to obtain articles published in English regarding the association of temperament and bipolar disorder. Keywords used were “temperament”, “bipolar disorder”, “assessment”, “bipolar spectrum”, “subthreshold”.

Results

In opposition to the dichotomic conception which up to the end of XIX century considered mania and depression as two distinct and separate categories, Kraepelin has postulated a psychopathological “continuum” between temperament and affective disorders called “bipolar spectrum”. This concept has been reintroduced in contemporary psychiatry by Akiskal's works. By rebuilding the history of patients affected by bipolar disorder, temperamental traits can be already observed in the pre-morbid period and can also persist during disorder-free intervals.

Conclusions

By interpreting and diagnosing multiple expressions of bipolar spectrum, psychiatrists today are facing one of the most important challenges in everyday clinical practice. The temperamental “dysregulation” is the pathological basis of mood disorders and some temperamental traits in individuals can reflect a predisposition to develop a mood disorder.

Type
P01-214
Copyright
Copyright © European Psychiatric Association 2011
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