Cyclothymic temperament: Associations with ADHD, other psychopathology, and medical morbidity in the general population

Abstract

Background: Cyclothymic temperament (CT) is an affective disposition often preceding bipolar disorder (BD), and is the most common affective temperament in patients with BD. In depressed patients, CT is a predictor for developing a bipolar course. In a clinical sample of adults with BD and attention deficit hyperactivity disorder (ADHD), CT was associated with higher loads of psychiatric symptoms, somatic comorbidity, impairment, and higher morbidity among first-degree relatives. We aimed to investigate the morbidity and occupational functioning of persons with CT in the general population.Methods: Randomly recruited Norwegian adults (n = 721) were assessed with a 21-item cyclothymic subscale from the TEMPS Autoquestionnaire. Self-reported data were collected on psychiatric symptoms, comorbidity, educational and occupational level, and known family morbidity.Results: Thirteen percent had CT associated with an increased prevalence of ADHD, BD, high scores on the Mood Disorder Questionnaire (MDQ), and childhood and adulthood ADHD symptoms. CT was found in 75% (p<0.001) of the bipolar participants, and in 68% (p<0.001) of those with a positive MDQ score. CT was associated with more anxiety/depression, substance and alcohol problems, lower educational and occupational levels, and having a first-degree relative with anxiety/depression, alcohol problems, ADHD, and BD. Limitations:The CT subscale alone might include overlapping features with cyclothymic, anxious, irritable, and depressed temperaments, thus increasing the prevalence estimate of CT.Conclusions: CT is a strong predictor of occupational failure and associated with more psychiatric impairment in the participants and their families. CT should be assessed in both mood disorder and ADHD patients.

Enduring effect of abuse: Childhood maltreatment links to altered theory of mind network among adults

“…The present finding was consistent with a previous study that traumarelated reduced FC between IPL and ACC was associated with heightened affective and anxiety symptoms (Eckstrand et al, 2019). As the personality traits, a higher level of anxious temperament means an increased risk of developing anxiety and depressive disorders (Kalin, 2017), whereas a higher level of cyclothymic temperament is one of the prodromal states of bipolar disorder (Syrstad et al, 2020).…”

“…The present finding was consistent with a previous study that trauma‐related reduced FC between IPL and ACC was associated with heightened affective and anxiety symptoms (Eckstrand et al, 2019). As the personality traits, a higher level of anxious temperament means an increased risk of developing anxiety and depressive disorders (Kalin, 2017), whereas a higher level of cyclothymic temperament is one of the prodromal states of bipolar disorder (Syrstad et al, 2020). Accordingly, we boldly speculated that the altered cognitive ToM connectomes might be the underlying neural mechanism for how maltreatment increases the risk for the development of psychiatric disorders such as major depressive disorder, anxiety disorder, and bipolar disorder.…”

Comparison of Emotional Dysregulation Features in Cyclothymia and Adult ADHD

“…A selection bias could be assumed, given that the sample was clinically referred to a tertiary level service specialized in mood disorders. However, cyclothymic temperament has been previously reported, on average, in 18% of adult ADHD patients recruited in other clinical settings [ 25 , 26 ] and in more than half of subjects with a positive screening for ADHD in a recent epidemiological study [ 27 ].…”

Accurate Identification of ADHD among Adults Using Real-Time Activity Data

“…Adult ADHD tends to be characterized by inattention, which manifests itself as disorganization and distraction-, task- and focus-related difficulties, as well as a proclivity for daydreaming [ 6 ]. Adult ADHD is usually linked to other mental conditions such as depression, mood, anxiety and sleeplessness [ 7 , 8 ]. Moreover, the symptoms of ADHD frequently coincide with those of other psychiatric illnesses, such as affective and internalizing disorders, autism spectrum disorder, and autistic-like features [ 9 ].…”