title: Temperament and prodromal symptoms prior to first manic/hypomanic episodes: results from a pilot study.
abstract: BACKGROUND
  Prodromal symptoms prior to first episode mania/hypomania have been reported. However, the relationship between temperament and manic/hypomanic prodromal symptoms has not been investigated. We hypothesized that subjects scoring higher on cyclothymic and irritable temperament scales show more manic/hypomanic prodromal symptoms.
  
  
  METHODS
  Euthymic patients diagnosed with bipolar-I or -II disorder within 8 years underwent retrospective assessments with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire (TEMPS-A) and the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R).
  
  
  RESULTS
  Among 39 subjects (36.1 ± 9.9 years, females = 59%, bipolar-I = 62%) 100% and 92.3% reported subthreshold mania (mean = 7.4 ± 2.9) or subthreshold depressive symptoms (mean = 2.4 ± 1.5), and 87.2% and 43.6% reported general psychopathology (mean = 3.2 ± 2.0) or subthreshold psychotic symptoms (mean = 0.7 ± 1.0) prior to their first hypo-/manic episode. Subjects with higher cyclothymic and irritable temperament scores showed more subthreshold symptoms prior to the first manic/hypomanic episode, mainly subthreshold hypo-/manic symptoms (cyclothymic temperament r = 0.430; p = 0.006; irritable temperament r = 0.330; p = 0.040), general psychopathology symptoms (cyclothymic temperament r = 0.316; p = 0.05; irritable temperament r = 0.349; p = 0.029) and subthreshold psychotic symptoms (cyclothymic temperament r = 0.413; p = 0.009). In regression analyses, cyclothymic temperament explained 16.1% and 12.5% of the variance of the BPSS-R total score (p = 0.045) and psychosis subscore (p = 0.029).
  
  
  CONCLUSIONS
  Retrospective study, no control group, small sample size.
  
  
  CONCLUSIONS
  We present data, which indicate a relationship between cyclothymic and irritable temperament and prodromal symptoms prior to the first manic/hypomanic episode. These findings support the notion that assessing cyclothymic temperament to identify people at-risk of developing bipolar-I and -II disorder may help to increase the predictive validity of applied at-risk criteria.
authors.affiliation: Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany.
authors.forename: Eike
authors.initials: E
authors.lastname: Zeschel
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Germany.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Bingmann
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Cologne, Germany. Electronic address: andreas.bechdolf@vivantes.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Bechdolf
authors.affiliation: Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany.
authors.forename: Seza
authors.initials: S
authors.lastname: Krüger-Oezguerdal
authors.affiliation: Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.
authors.forename: Christoph U
authors.initials: CU
authors.lastname: Correll
authors.affiliation: Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Germany.
authors.forename: Karolina
authors.initials: K
authors.lastname: Leopold
authors.affiliation: Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pfennig
authors.affiliation: Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, Technische Universität Dresden, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Department of Psychiatry, Ruhr-University Bochum, LWL University Hospital, Bochum, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Juckel
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D010865:Pilot Projects; D062706:Prodromal Symptoms; D012189:Retrospective Studies; D013694:Temperament; D055815:Young Adult
keywords: Bipolar disorder; Hypomania; Mania; Prodrome; Temperament