title: Affective temperaments and concomitant alcohol use disorders in bipolar disorder.
abstract: BACKGROUND
  Alcohol misuse (AM) is more common in bipolar disorder (BD) than within the general population but the mechanisms of this association are unclear. We hypothesized that certain affective temperaments (including hyperthymic, cyclothymic, anxious, depressive and/or irritability) might represent 'fundamental states' contributing to risk of both AM and BD and we aimed to assess whether extremes of these five affective temperaments were associated with BD and concomitant AM status.
  
  
  METHODS
  Our sample comprised 1420 individuals with BD who were recruited into a clinical-genetic study conducted by the Bipolar Disorder Research Network. Phenotypic assessments, including evaluation for AM and the 32-item TEMPS-A questionnaire, were conducted. Binary logistic regression was used to determine the effect of TEMPS-A scores on the likelihood of concomitant AM, with adjustment for confounders.
  
  
  RESULTS
  Mean scores for four affective temperaments (hyperthymic, cyclothymic, depressive and irritable) were higher in cases (BD+AMs) than controls (BD only) (p<0.001). Hyperthymic and irritable temperaments in particular significantly increased the odds of concomitant AM within the BD sample after adjustment for potential confounders.
  
  
  CONCLUSIONS
  The definition of AM was not directly based on formal diagnostic classification systems. A retrospective, cross-sectional design was used. Our findings may not generalize to other countries and cultures.
  
  
  CONCLUSIONS
  Higher scores on measures of hyperthymic and irritable temperament may contribute to the association between AM and BD. Assessing affective temperaments early in the course of BD may help to predict the development of an AM problem in vulnerable individuals.
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
authors.forename: Sukhmeet
authors.initials: S
authors.lastname: Singh
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
authors.forename: Liz
authors.initials: L
authors.lastname: Forty
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
authors.forename: Arianna
authors.initials: A
authors.lastname: di Florio
authors.affiliation: Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gordon-Smith
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Jones
authors.affiliation: Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Craddock
authors.affiliation: Department of Psychiatry, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK.
authors.forename: Lisa
authors.initials: L
authors.lastname: Jones
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK. Electronic address: daniel.smith@glasgow.ac.uk.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Smith
mesh_terms: D000328:Adult; D000339:Affect; D019973:Alcohol-Related Disorders / Q000150:complications* / Q000523:psychology*; D001714:Bipolar Disorder / Q000150:complications* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013694:Temperament
keywords: Affective temperament; Alcohol misuse; Bipolar disorder