title: Differential associations of affective temperaments and diagnosis of major affective disorders with suicidal behavior.
abstract: Affective temperaments are associated with suicidal risk, but their predictive value relative to diagnosis of major affective disorder is uncertain.
  
  
  
  We compared diagnoses, affective-temperament ratings (TEMPS-A), and other potential risk factors in 956 psychiatric inpatients, using bivariate analyses and multivariable logistic regression modeling for associations with suicidal status.
  
  
  
  Lifetime suicide-attempt rates were high (43.9% overall), ranking by diagnosis: bipolar-II (58.4%), major depressive (50.0%), bipolar-I (44.6%), other (38.0%), and psychotic (33.9%) disorders. TEMPS-A scores for depressive (dep), cyclothymic (cyc), irritable (irr), and anxious (anx) temperaments and their sum were strongly associated with suicidal risk; hyperthymic (hyp) temperament scores were inversely associated; and a composite measure (dep+cyc+irr+anx - hyp), even more strongly associated. The composite score was highly, independently associated with suicidal behavior (p<0.0001), as was female sex (p=0.0002), but older age and diagnosis of major affective disorder, much less (both p=0.02).
  
  
  
  Measures of affective temperament-types were independently and more strongly associated with lifetime suicide attempt than was diagnosis of a major affective disorder. However, in this hospitalized cohort, suicide rates were high across diagnoses, possibly limiting the predictive value of diagnosis.
authors.affiliation: International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA. Electronic address: rbaldessarini@mclean.harvard.edu.
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
authors.affiliation: Department of Human Sciences, European University of Rome, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Innamorati
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Denise
authors.initials: D
authors.lastname: Erbuto
authors.affiliation: Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.affiliation: Department of Psychiatry, University of Naples SUN, Naples, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fiorillo
authors.affiliation: Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Amore
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Girardi
authors.affiliation: International Consortium for Mood & Psychotic Disorders Research, Mailman Research Center, McLean Hospital, Belmont, MA, USA; Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D000367:Age Factors; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012737:Sex Factors; D059020:Suicidal Ideation; D013405:Suicide / Q000523:psychology*; D013406:Suicide, Attempted / Q000706:statistics & numerical data; D013694:Temperament
keywords: Affective temperaments; Major affective disorders; Suicide attempts; TEMPS-A