2. Academic Validation
  3. Clinical characteristics and temperament influences on 'happy' euphoric and 'snappy' irritable bipolar hypo/manic mood states

Clinical characteristics and temperament influences on 'happy' euphoric and 'snappy' irritable bipolar hypo/manic mood states

  • J Affect Disord. 2015 Mar 15;174:144-9. doi: 10.1016/j.jad.2014.11.042.
Rebecca K Graham 1,  Gordon B Parker 2,  Michael Breakspear 3,  Philip B Mitchell 1
Affiliations

Affiliations

  • 1 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia.
  • 2 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia. Electronic address: [email protected].
  • 3 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Hospital Road, Prince of Wales Hospital, Randwick, Sydney, NSW 2031, Australia; QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
PMID: 25497471 DOI: 10.1016/j.jad.2014.11.042
Abstract

Background: While mood elevation and euphoria are the most commonly described phenotypic descriptors of hypo/mania, irritability and anger may dominate. This study was designed to pursue possible determinants of such differing states.

Methods: Patients with bipolar I or II disorder were assigned to an 'irritable/snappy' or 'euphoric/happy' sub-set on the basis of their dominant hypo/manic symptoms. Group differences were examined across clinical, personality, lifestyle and illness impact measures.

Results: The two sub-sets did not differ on age of depression onset, family history of mood disorders, or depression severity and impairment. The snappy sub-set reported higher levels of irritability in depressed phases and were more likely to have a comorbid anxiety disorder. Their hypo/manic episodes were shorter and they were more likely to be hospitalized at such times. On a temperament measure they scored as more irritable and self-focussed and as less cooperative and effective - indicative of higher levels of disordered personality functioning.

Limitations: Some comparison analyses were undertaken on a reduced sample size, giving rise to power issues. Our bipolar I and II diagnoses deviated to some extent from DSM-5 criteria in not imposing duration criteria for hypo/manic episodes.

Conclusions: Findings support a spectrum model for the bipolar disorders linking temperament to bipolar symptomatic state and which may have treatment implications.

Keywords

Bipolar disorder; Hypomania; Mania; Temperament.

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