title: The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness.
abstract: Bipolar disorder constitutes a challenge for clinicians in everyday clinical practice. Our knowledge concerning this clinical entity is incomplete, and contemporary classification systems are unable to reflect the complexity of this disorder. The concept of temperament, which was first described in antiquity, provides a helpful framework for synthesizing our knowledge on how the human body works and what determines human behavior. Although the concept of temperament originally included philosophical and sociocultural approaches, the biomedical model is dominant today. It is possible that specific temperaments might constitute vulnerability factors, determine the clinical picture, or modify the course of illness. Temperaments might even act as a bridge between genes and clinical manifestations, thus giving rise to the concept of the bipolar spectrum, with major implications for mental health research and treatment. More specifically, it has been reported that the hyperthymic and the depressive temperaments are related to the more "classic" bipolar disorder, whereas cyclothymic, anxious, and irritable temperaments are related to more complex manifestations and might predict poor response to treatment, violent or suicidal behavior, and high comorbidity. Incorporating of the concept of temperament and the bipolar spectrum into the standard training of psychiatric residents might well result in an improvement of everyday clinical practice.
authors.affiliation: From the 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki (Greece) (Dr. Fountoulakis and Ms. Koufaki); Departments of Clinical and Theoretical Mental Health, Kutvolgyi Clinical Center, and of Pharmacodynamics, Semmelweis University (Hungary) (Dr. Gonda); Hungarian Academy of Science-Semmelweiss University Neuropsychopharmacology and Neurochemistry Research Group, Budapest (Dr. Gonda); Department of Psychiatry, School of Medicine, University of Ioannina, Greece (Dr. Hyphantis); Department of Psychiatry, School of Medicine, Washington University in St. Louis (Dr. Cloninger).
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Fountoulakis
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.forename: Ioanna
authors.initials: I
authors.lastname: Koufaki
authors.forename: Thomas
authors.initials: T
authors.lastname: Hyphantis
authors.forename: C Robert
authors.initials: CR
authors.lastname: Cloninger
mesh_terms: D001714:Bipolar Disorder / Q000209:etiology / Q000235:genetics / Q000523:psychology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D010551:Personality; D012737:Sex Factors; D013694:Temperament