TEMPS‐A (short version) plays a supplementary role in the differential diagnosis between major depressive disorder and bipolar disorder

Abstract

Aim: Early differential diagnosis between patients with major depressive disorder (MDD) and bipolar disorder (BD), and subsequently providing appropriate treatments are essential. There has been increased interest regarding the association between affective temperaments and mood disorder diagnosis. Our aim was to analyze the diagnostic validity of affective temperaments assessed by the short version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-autoquestionnaire version (TEMPS-A), in mood disorder patients.Methods: Inpatients with MDD (n = 146) or BD (n = 128) completed the short version of TEMPS-A, and their depressive and manic symptom severities were evaluated. Data of MDD and BD patients were compared by univariable and multivariable analyses.Results: Of the five affective temperament dimensions, substantially higher hyperthymic, irritable, and cyclothymic temperament scores were found in BD patients than in MDD patients. Using a multivariable logistic regression model built using the severities of depressed and manic conditions, and the five affective temperament subscale scores as independent variables, we identified two factors statistically associated with BD diagnosis (anxious temperament and cyclothymic temperament). The recommended cutoff point for the 12 items evaluating cyclothymic temperament to differentiate BD from MDD was 8 or more 'True' items (sensitivity: 35.9%, specificity: 87.7%).Limitations: Our design was cross-sectional, and therefore, there was a possibility of longitudinal diagnostic conversion of patients from MDD to BD. Conclusion:Cyclothymic and anxious temperaments on the short version of TEMPS-A, identified as diagnostic differentiating factors between MDD and BD, may play supplementary roles in the early identification of BD.

Relationships of affective temperament ratings to diagnosis and morbidity measures in major affective disorders

“…Consistent with our findings, Morishita et al [ 29 , 30 ] found that cyclothymic and anxious temperament scores significantly differentiated the diagnosis of BD from MDD and statistically associated with BD by using multivariable logistic regression modeling. However, those studies also found that higher hyperthymic temperament scores differentiated subjects diagnosed with BD-1 versus BD-2, which we did not find ( Table 1 ).…”

“…However, those studies also found that higher hyperthymic temperament scores differentiated subjects diagnosed with BD-1 versus BD-2, which we did not find ( Table 1 ). The studies by Morishita et al [ 29 , 30 ] were based on a cross-sectional design and so may have missed some patients considered to have MDD who might later have met diagnostic criteria for BD [ 5 , 37 , 38 ]. Moreover, not all of their patients were currently in remission or euthymic, and some responses to temperament categorizing questions may have been influenced by current mood states [ 34 , 39 ].…”

“…Several studies have focused on temperament assessments in individuals diagnosed with MDD [15][16][17] or with BD specifically [18][19][20][21][22][23][24], or have considered mood disorders together using TCI [25,26] or TEMPS [1,[27][28][29][30]. Such studies have revealed differences between mood disorder patients and controls, including unaffected family members, with suggestive differences between BD and MDD patients and possibly between BD-1 and BD-2 patients based on ratings of cyclothymic, hyperthymic, and irritable temperaments, in particular, as well as ratings of harm-avoidance [1,[31][32][33].…”

Effects of the Interaction between Affective Temperaments and BIS/BAS on Depressive Symptoms in Individuals with Major Depressive Disorder

“…Cronbach’s α for a 39-item version of TEMPS-A with 12 CycT, eight DepT, eight IrrT, eight HypT, and three AnxT subscales was 0.91 (CycT), 0.81 (DepT), 0.77 (IrrT), 0.76 (HypT), and 0.67 (AnxT) [ 16 ]. The 39-item Japanese short version of the TEMPS-A was used in this study [ 19 , 36 ].…”

“…Although cultural factors can affect the expression of ATs [ 14 ], CycT and IrrT develop on a continuum of temperaments, from healthy through MDD to bipolar disorder [ 18 ]. CycT and AnxT are factors of differential diagnosis between MDD and bipolar disorder in Japan and are associated with the diagnosis of bipolar disorder [ 19 ]. In Japanese patients with MDD, the severity of depressive symptoms (DepS) is considered directly influenced by DepT, CycT, IrrT, and AnxT [ 20 ].…”