Bipolar II Disorder and Its Premorbid Personality

Abstract

This study psychopathologically analyzes and compares the premorbid personalities associated with bipolar II disorder and unipolar depression. Using Cloninger’s tridimensional personality theory, we evaluated 14 inpatients with bipolar II disorder and 14 inpatients with unipolar depression. The results indicate that the premorbid personality associated with bipolar II disorder is characterized as ‘the reward-dependent, passive-avoidant/dependent tendency of personality’ or ‘the dependent tendency of personality’. We also clarified that atypical symptoms of bipolar II disorder, such as the hypomanic state and the mixed state, were induced by the mingling of this tendency with the melancholic personality type (Tellenbach) or the cycloid personality type (Kretschmer), both of which are based on syntony (Minkowski), categorized by the use of an obsessional defense mechanism to maintain stable social relations. When an insufficiency in the obsessional defense weakens the syntony, the dependent tendency engenders the symptoms stated above. Although few serious problems associated with the dependent tendency may have occurred previously, it may have resulted in conflicts with others after onset of the bipolar II disorder. Therefore, psychotherapy for these conflicts is necessary along with the administration of mood stabilizers.

Bipolar II disorder: a review

“…Other studies found more dependant, obsessive, histrionic traits, reward‐dependant, passive avoidant/dependant and similar personality profiles to unipolar disorder. More borderline features in bipolar II disorder is the single most consistent finding (7, 23, 46, 67–75). When one examines patients with borderline personality diagnoses, some 66% of borderlines have comorbid affective diagnoses (76), with bipolar II being particularly over‐represented (77).…”

The relationship of personality traits to substance abuse in patients with bipolar disorder

“…No study has been published using the newer TCI. Based on this model, some studies have tried to assess differences between the personality characteristics of the general population and patients with BD [11,21,22], BD type I and type II [14,29], as well as manic, euthymic and depressed states of BD [27]. Although the consistency of the results is poor and more studies are needed, we are going to assume for this research the following hypothesis: specific personality traits can serve as a phenotype marker for the genetic–neurochemical diathesis to BD [21].…”

Personality disorder comorbidity among patients with bipolar I disorder in remission

“…The identification of comorbid personality traits or disorders in patients with mood disorders has received considerable attention in recent years (1–5). Although the major focus of studies regarding comorbid personality disorders were initially on depression, studies searching for the relationship between bipolar disorder (BD) and personality disorder (PD) have been on the increase during the last decade (5–18). The presence of comorbid PD has been shown to be a prominent factor affecting symptom severity and course in BD patients.…”