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BMC Psychiatry
Published in: BMC Psychiatry 1/2017

Open Access 01-12-2017 | Research article

Personality traits in bipolar disorder and influence on outcome

Authors: Timea Sparding, Erik Pålsson, Erik Joas, Stefan Hansen, Mikael Landén

Published in: BMC Psychiatry | Issue 1/2017

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Abstract

Background

The aim was to investigate the personality profile of bipolar disorder I and II, and healthy controls, and to study whether personality influences the course of bipolar disorder.

Methods

One hundred ten patients with bipolar disorder I, 85 patients with bipolar disorder II, and 86 healthy individuals had their personality profile assessed using the Swedish universities Scales of Personality (SSP), an instrument developed to explore personality-related vulnerabilities and correlates of psychiatric disorders. Patients were followed prospectively for 2 years. To assess the impact of Neuroticism, Aggressiveness, and Disinhibition on illness course, we performed logistic regressions with the outcome variables mood episodes (depressive, hypo/manic, mixed), suicide attempts, violence, and the number of sick leave days.

Results

Bipolar disorder I and II demonstrated higher global measures of Neuroticism, Aggressiveness, and Disinhibition as compared with healthy controls. A third of the patients scored ≥1 SD above the population-based normative mean on the global neuroticism measure. The two subtypes of bipolar disorder were, however, undistinguishable on all of the personality traits. In the unadjusted model, higher neuroticism at baseline predicted future depressive episodes and suicide attempts/violent behavior, but this association disappeared when adjusting for baseline depressive symptoms as assessed with MADRS.

Conclusions

A significant minority of the patients scored ≥1 SD above the population mean on the global measures of Neuroticism, Aggressiveness and Disinhibition; scores this high are usually evident clinically. Yet, the personality profile does not seem to have prognostic value over a 2-year period.
Literature
1.
2.
Kraepelin E. Manic depressive insanity and paranoia. J Nerv Ment Dis. 1921;53(4):350.CrossRef
3.
Smillie LD, Bhairo Y, Gray J, Gunasinghe C, Elkin A, McGuffin P, Farmer A. Personality and the bipolar spectrum: normative and classification data for the Eysenck Personality Questionnaire-Revised. Compr Psychiatry. 2009;50(1):48–53.CrossRefPubMed
4.
Engström C, Brändström S, Sigvardsson S, Cloninger R, Nylander P-O. Bipolar disorder: I. Temperament and character. J Affect Disord. 2004;82(1):131–4.CrossRefPubMed
5.
Solomon DA, Shea MT, Leon AC, Mueller TI, Coryell W, Maser JD, Endicott J, Keller MB. Personality traits in subjects with bipolar I disorder in remission. J Affect Disord. 1996;40(1):41–8.CrossRefPubMed
6.
Jylhä P, Mantere O, Melartin T, Suominen K, Vuorilehto M, Arvilommi P, Leppämäki S, Valtonen H, Rytsälä H, Isometsä E. Differences in neuroticism and extraversion between patients with bipolar I or II and general population subjects or major depressive disorder patients. J Affect Disord. 2010;125(1):42–52.CrossRefPubMed
7.
Barnett J, Huang J, Perlis R, Young M, Rosenbaum J, Nierenberg A, Sachs G, Nimgaonkar V, Miklowitz D, Smoller J. Personality and bipolar disorder: dissecting state and trait associations between mood and personality. Psychol Med. 2011;41(08):1593–604.CrossRefPubMed
8.
Nowakowska C, Strong CM, Santosa CM, Wang PW, Ketter TA. Temperamental commonalities and differences in euthymic mood disorder patients, creative controls, and healthy controls. J Affect Disord. 2005;85(1):207–15.CrossRefPubMed
9.
Muhtadie L, Johnson SL, Carver CS, Gotlib IH, Ketter TA. A profile approach to impulsivity in bipolar disorder: the key role of strong emotions. Acta Psychiatr Scand. 2014;129(2):100–8.CrossRefPubMed
10.
Judd LL, Akiskal HS, Schettler PJ, Coryell W, Maser J, Rice JA, Solomon DA, Keller MB. The comparative clinical phenotype and long term longitudinal episode course of bipolar I and II: a clinical spectrum or distinct disorders? J Affect Disord. 2003;73(1):19–32.CrossRefPubMed
11.
Akiskal HS, Kilzieh N, Maser JD, Clayton PJ, Schettler PJ, Shea MT, Endicott J, Scheftner W, Hirschfeld RM, Keller MB. The distinct temperament profiles of bipolar I, bipolar II and unipolar patients. J Affect Disord. 2006;92(1):19–33.CrossRefPubMed
12.
Wu P-J, Chang S-M, Lu M-K, Chen WJ, Yang Y-K, Liao S-C, Lu R-B, Kuo P-H. The profile and familiality of personality traits in mood disorder families. J Affect Disord. 2012;138(3):367–74.CrossRefPubMed
13.
Cloninger CR, Przybeck TR, Svrakic DM. The Temperament and Character Inventory (TCI): A guide to its development and use: . Louis: Center for Psychobiology of Personality, Washington University St; 1994.
14.
Dervic K, Garcia-Amador M, Sudol K, Freed P, Brent D, Mann J, Harkavy-Friedman J, Oquendo M. Bipolar I and II versus unipolar depression: clinical differences and impulsivity/aggression traits. Eur Psychiatry. 2015;30(1):106–13.CrossRefPubMed
15.
Fletcher K, Parker G, Barrett M, Synnott H, McCraw S. Temperament and personality in bipolar II disorder. J Affect Disord. 2012;136(3):304–9.CrossRefPubMed
16.
Hecht H, van Calker D, Berger M, von Zerssen D. Personality in patients with affective disorders and their relatives. J Affect Disord. 1998;51(1):33–43.CrossRefPubMed
17.
Gustavsson JP, Bergman H, Edman G, Ekselius L, Von Knorring L, Linder J. Swedish universities Scales of Personality (SSP): construction, internal consistency and normative data. Acta Psychiatr Scand. 2000;102(3):217–25.CrossRefPubMed
18.
Aluoja A, Voogne H, Maron E, Gustavsson JP, Võhma Ü, Shlik J. Personality traits measured by the Swedish universities Scales of Personality: Factor structure and position within the five-factor model in an Estonian sample. Nord J Psychiatry. 2009;63(3):231–6.CrossRefPubMed
19.
Ekman C, Lind J, Ryden E, Ingvar M, Landen M. Manic episodes are associated with grey matter volume reduction-a voxel‐based morphometry brain analysis. Acta Psychiatr Scand. 2010;122(6):507–15.CrossRefPubMed
20.
Ryden E, Thase M, Stråht D, Åberg‐Wistedt A, Bejerot S, Landén M. A history of childhood attention‐deficit hyperactivity disorder (ADHD) impacts clinical outcome in adult bipolar patients regardless of current ADHD. Acta Psychiatr Scand. 2009;120(3):239–46.CrossRefPubMed
21.
Sachs GS, Thase ME, Otto MW, Bauer M, Miklowitz D, Wisniewski SR, Lavori P, Lebowitz B, Rudorfer M, Frank E. Rationale, design, and methods of the systematic treatment enhancement program for bipolar disorder (STEP-BD). Biol Psychiatry. 2003;53(11):1028–42.CrossRefPubMed
22.
Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59:22–33.PubMed
23.
Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry J Ment Sci. 1995;166(5):654–9.CrossRef
24.
Åsberg M, Schalling D. Construction of a new psychiatric rating instrument, the Comprehensive Psychopathological Rating Scale (CPRS). Prog Neuropsychopharmacol. 1979;3(4):405–12.CrossRefPubMed
25.
Young R, Biggs J, Ziegler V, Meyer D. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133(5):429–35.CrossRefPubMed
26.
Jakobsson J, Zetterberg H, Blennow K, Ekman CJ, Johansson AG, Landén M. Altered concentrations of amyloid precursor protein metabolites in the cerebrospinal fluid of patients with bipolar disorder. Neuropsychopharmacology. 2013;38(4):664–72.CrossRefPubMed
27.
Hood SD, Shufflebotham JQ, Hendry J, Hince DA, Rich AS, Probert CS, Potokar J. Irritable Bowel Syndrome patients exhibit depressive and anxiety scores in the subsyndromal range. Open Psychiatry J. 2008;2008:2.
28.
Deary IJ, Weiss A, Batty GD. Intelligence and personality as predictors of illness and death how researchers in differential psychology and chronic disease epidemiology are collaborating to understand and address health inequalities. Psychol Sci Public Interest. 2010;11(2):53–79.CrossRefPubMed
29.
Albert D, Walsh M, Jonik R. Aggression in humans: what is its biological foundation? Neurosci Biobehav Rev. 1994;17(4):405–25.CrossRef
30.
Gray LN, Tallman I. Theories of choice: Contingent reward and punishment applications. Soc Psychol Q. 1987;1987:16–23.CrossRef
31.
Paris J, Gunderson J, Weinberg I. The interface between borderline personality disorder and bipolar spectrum disorders. Compr Psychiatry. 2007;48(2):145–54.CrossRefPubMed
32.
Matthews G, Deary IJ, Whiteman MC. Personality Traits: Cambridge University Press. 2009.CrossRef
33.
Parker G, Manicavasagar V, Crawford J, Tully L, Gladstone G. Assessing personality traits associated with depression: the utility of a tiered model. Psychol Med. 2006;36(08):1131–9.CrossRefPubMed
34.
Akiskal HS, Hirschfeld R, Yerevanian BI. The relationship of personality to affective disorders: a critical review. Arch Gen Psychiatry. 1983;40(7):801.CrossRefPubMed
35.
Clark LA, Watson D, Mineka S. Temperament, personality, and the mood and anxiety disorders. J Abnorm Psychol. 1994;103(1):103.CrossRefPubMed
36.
Gingnell M, Comasco E, Oreland L, Fredrikson M, Sundström-Poromaa I. Neuroticism-related personality traits are related to symptom severity in patients with premenstrual dysphoric disorder and to the serotonin transporter gene-linked polymorphism 5-HTTPLPR. Arch Womens Ment Health. 2010;13(5):417–23.CrossRefPubMedPubMedCentral
37.
Elfhag K. Personality correlates of obese eating behaviour: Swedish universities Scales of Personality and the Three Factor Eating Questionnaire. Eat Weight Disorders-Studies Anorexia Bulimia Obes. 2005;10(4):210–5.CrossRef
38.
Ramklint M, Ekselius L. Personality traits and personality disorders in early onset versus late onset major depression. J Affect Disord. 2003;75(1):35–42.CrossRefPubMed
39.
Võhma Ü, Aluoja A, Vasar V, Shlik J, Maron E. Evaluation of personality traits in panic disorder using Swedish universities Scales of Personality. J Anxiety Disord. 2010;24(1):141–6.CrossRefPubMed
40.
Fagerberg T, Söderman E, Gustavsson JP, Agartz I, Jönsson EG. Personality traits in established schizophrenia: aspects of usability and differences between patients and controls using the Swedish universities Scales of Personality. Nord J Psychiatry. 2016;70(6):462–9.CrossRefPubMedPubMedCentral
41.
Willebrand M, Kildal M, Andersson G, Ekselius L. Long-term assessment of personality after burn trauma in adults. J Nerv Ment Dis. 2002;190(1):53–6.CrossRefPubMed
42.
Caspi A, Houts RM, Belsky DW, Goldman-Mellor SJ, Harrington H, Israel S, Meier MH, Ramrakha S, Shalev I, Poulton R. The p factor one general psychopathology factor in the structure of psychiatric disorders? Clin Psychol Sci. 2014;2(2):119–37.CrossRefPubMedPubMedCentral
43.
44.
Wilson TD. Strangers to ourselves: Harvard University Press. 2004.
Metadata
Title
Personality traits in bipolar disorder and influence on outcome
Authors
Timea Sparding
Erik Pålsson
Erik Joas
Stefan Hansen
Mikael Landén
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2017
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-017-1332-0

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