Temperament and Personality Dimensions in Suicidal and Nonsuicidal Psychiatric Inpatients

Abstract

Background: Suicide is a serious public health problem. In the international literature there is evidence to support the notion that certain temperaments and personality traits are often associated with suicidal behavior. Sampling and Methods: In this study, 150 psychiatric inpatients were investigated using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego autoquestionnaire, the Minnesota Multiphasic Personality Inventory, 2nd edition (MMPI-2) and the Beck Hopelessness Scale and evaluated for suicide risk by means of the critical items of the Mini International Neuropsychiatric Interview. Results: Statistical analysis, including logistic regression analysis and multiple regression analysis, showed that suicide risk contributed to the prediction of hopelessness. Among the temperaments, only the hyperthymic temperament, as a protective factor, and the dysthymic/cyclothymic/anxious temperament contributed significantly to the prediction of hopelessness. Irritable temperament and social introversion were predictive factors for suicidal risk. Hopelessness and depression were associated with higher suicidal behavior and ideation, but, unexpectedly, depression as measured by the MMPI did not contribute significantly to the multiple regressions. Conclusions: The present study indicated that, although suicidal psychiatric patients have MMPI-2 profiles in the pathological range, they exhibit several differences from nonsuicidal patients. Patients at risk of suicide have specific temperaments as well as personality and defense mechanism profiles. They are more socially introverted, depressed and psychasthenic, and use hysterical and schizoid mechanisms more often. Generalizability of the findings was limited by the small sample size and the mix of bipolar disorder I, bipolar disorder II, major depressive disorder and psychotic disorder patients.

The Role of Temperament in the Etiopathogenesis of Bipolar Spectrum Illness

“…The anxious temperament has been shown to be a strong and general predictor of several mental illnesses especially within the anxiety and depressive clusters. On the contrary, the hyperthymic temperament has been shown to have a uniquely protective effect against the majority of psychiatric disorders (with few exceptions including bipolar disorder) 109,110 . The dysthymic, cyclothymic and anxious temperaments are related to hopelessness and the irritable temperament to suicidality 110 .…”

“…On the contrary, the hyperthymic temperament has been shown to have a uniquely protective effect against the majority of psychiatric disorders (with few exceptions including bipolar disorder) 109,110 . The dysthymic, cyclothymic and anxious temperaments are related to hopelessness and the irritable temperament to suicidality 110 . Besides, several studies described the association of each of these temperaments or specific temperamental constellations with specific mental disorders.…”

“…A constellation of dysthymic, cyclothymic and anxious temperaments is related to hopelessness (known to be a strong and independent predictor of suicidal behavior) with the irritable temperament related specifically to suicidality 110 . Lifetime suicide is related (among others) to depressive or mixed polarity of first episode and cyclothymic temperament 129 .…”

Risk assessment of a suicide in relation to a personality structure in patients with depression

“…U istraživanju Kupera, Osmana i Bariosa (28) kao značajan prediktor suicidalnog rizika kod žena ističu se subskale Histerije (Hy), Paranoje (Pa), Psihopatske devijacije (Pd) i Hipomanije (Ma). Šta više, kroz istraživanje Pomplija i saradnika (29) ističe se povezanost skoro svih subskala, osim (Pa i Ma), sa suicidalnošću, s tim što se dobija da je socijalna inkompatibilnost najbolji prediktor. Sa druge strane, vršeći meta-analizu podataka Kene (30) u svojoj disertaciji, dolazi do zaključaka da skale MMPI nisu koristan prediktor nijednog aspekta suicidalnosti.…”

“…Sa druge strane, stepen povezanosti i prediktivna moć pojedinih faktora se razlikuje. Šta više, u istraživanju Pomplija i saradnika (29), depresivnost se pokazala kao izrazito redudantan prediktor.…”