title: Temperament and suicide: A national study.
abstract: BACKGROUND
  Several studies have shown temperament variants in suicidality. Yet, to our knowledge, the association between temperaments and suicide attempts has not been studied on a nationally representative level nor systematically in subjects with no mental disorders. Also, although hyperthymic temperament is recognized as protective of most mental disorders, its role in the protection from self-harm remains inconclusive.
  
  
  METHODS
  The study is based on nationally representative data of all Lebanese adults. Mental disorders were assessed using the Composite International Diagnostic Interview, whereas the five affective temperaments were assessed using the TEMPS-A.
  
  
  RESULTS
  Anxious temperament is a solid and strong risk factor for suicide attempts in subjects with (OR: 10.1) and without (OR: 9.0) mental disorders. Depressive (OR: 4.3) and irritable (OR: 5.1) temperaments are risk factors for suicide attempt among subjects with mental disorders. Hyperthymic temperament plays a dual role in females with mental disorders: while the hyperthymic trait "having self-confidence" is strongly protective of suicide attempts, "liking to be the boss", "getting into heated arguments", and "the right and privilege to do as I please" are hyperthymic risk traits for suicide attempts reflecting the "dark side" of the hyperthymic temperament. Interestingly, these three hyperthymic risk traits--in the absence of "having self-confidence"--are a universal risk for suicide attempt in females with mental disorder.
  
  
  CONCLUSIONS
  Social desirability could have led to the under-reporting of suicide attempts and mental disorders.
  
  
  CONCLUSIONS
  The anxious temperament plays a strong role in predicting suicide attempts in the community, in the presence and absence of diagnosable mental disorders. The irritable and the depressive temperaments are additional risks in subjects with mental disorders. The dual role of the hyperthymic temperament is quite interesting: while it is protective of suicidal behavior, it also has a dark side in subjects with mental disorders.
authors.affiliation: Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry & Clinical Psychology, Saint George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon. Electronic address: egkaram@idraac.org.
authors.forename: Elie G
authors.initials: EG
authors.lastname: Karam
authors.affiliation: Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon.
authors.forename: Lynn
authors.initials: L
authors.lastname: Itani
authors.affiliation: Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry & Clinical Psychology, Saint George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: John
authors.initials: J
authors.lastname: Fayyad
authors.affiliation: Centre des Troubles Anxieux et de l'Humeur (CTAH), Paris, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Hantouche
authors.affiliation: Institute for Development, Research, Advocacy & Applied Care (IDRAAC), Beirut, Lebanon; Department of Psychiatry & Clinical Psychology, Saint George Hospital University Medical Center, Balamand University, Faculty of Medicine, Beirut, Lebanon.
authors.forename: Aimee
authors.initials: A
authors.lastname: Karam
authors.affiliation: Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Zeina
authors.initials: Z
authors.lastname: Mneimneh
authors.affiliation: International Mood Center, University of California at San Diego, La Jolla, CA, USA.
authors.forename: Hagop
authors.initials: H
authors.lastname: Akiskal
authors.affiliation: Department of Clinical and Theoretical Mental Health, Semmelweis University and National Institute of Psychiatry and Addictions, Budapest, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Rihmer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D005260:Female; D006801:Humans; D007508:Irritable Mood; D007861:Lebanon; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D065840:Protective Factors; D012307:Risk Factors; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology; D013694:Temperament; D055815:Young Adult
keywords: Hyperthymic; Suicide; Temperament