title: Temperaments mediate suicide risk and psychopathology among patients with bipolar disorders.
abstract: BACKGROUND
  Several studies have demonstrated that bipolar II (BD-II) disorder represents a quite common, distinct form of major mood disorders that should be separated from bipolar I (BD-I) disorder. The aims of this cross-sectional study were to assess temperament and clinical differences between patients with BD-I and BD-II disorders and to assess whether temperament traits are good predictors of hopelessness in patients with bipolar disorder, a variable highly associated with suicidal behavior and ideation.
  
  
  METHODS
  Participants were 216 consecutive inpatients (97 men and 119 women) with a Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), BD who were admitted to the Sant'Andrea Hospital's psychiatric ward in Rome (Italy). Patients completed the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego--Autoquestionnaire, the Beck Hopelessness Scale (BHS), the Mini International Neuropsychiatric Interview (MINI), and the Gotland Scale of Male Depression.
  
  
  RESULTS
  Patients with BD-II had higher scores on the BHS (9.78 ± 5.37 vs 6.87 ± 4.69; t(143.59) = -3.94; P < .001) than patients with BD-I. Hopelessness was associated with the individual pattern of temperament traits (ie, the relative balance of hyperthymic vs cyclothymic-irritable-anxious-dysthmic). Furthermore, patients with higher hopelessness (compared with those with lower levels of hopelessness) reported more frequently moderate to severe depression (87.1% vs 38.9%; P < .001) and higher MINI suicidal risk.
  
  
  CONCLUSIONS
  Temperaments are important predictors both of suicide risk and psychopathology and may be used in clinical practice for better delivery of appropriate care to patients with bipolar disorders.
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome 00189, Italy. maurizio.pompili@uniroma1.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Rihmer
authors.forename: Hagop
authors.initials: H
authors.lastname: Akiskal
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.forename: Marco
authors.initials: M
authors.lastname: Innamorati
authors.forename: David
authors.initials: D
authors.lastname: Lester
authors.forename: Giulio
authors.initials: G
authors.lastname: Perugi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.forename: Ludovica
authors.initials: L
authors.lastname: Telesforo
authors.forename: Roberto
authors.initials: R
authors.lastname: Tatarelli
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013694:Temperament