The temperaments and their role in early diagnosis of bipolar spectrum disorders.

BACKGROUND there is a public health issue regarding the correct diagnosis of BSD: these diseases are often underreferred, underdiagnosed and undertreated/mistreated. To fail to treat BSD may result in serious complications (loss of work, relationship crisis, substance-abuse, suicide, rapes, etc). In order to correctly diagnose Bipolar Spectrum Mood Disorders, it is important to know the patient's premorbid personality and past history: it is essential to know the longitudinal history and the full family history. METHODS 423 patients, who were recruited and assessed over six years have been reassessed to demonstrate their temperaments, as these emerge from their personal anamnesis. RESULTS more patients within the series appear to have a soft bipolar illness than a major unipolar depression; the depressive episodes are now considered as only one phase of the bipolar spectrum. Furthermore, every patient with bipolar spectrum disorder already presented in their personal history of the illness a sub-clinical evidence of one of the temperaments (hyperthymic temper.: 35%; cyclothymic temper.: 49%; depressive temper.: 16%). DISCUSSION the different temperaments are described, and their significance elucidated. CONCLUSIONS the subthreshold presence of the temperaments in the history of the patients with bipolar spectrum disorders leads us to consider this to be an important method of early diagnosis of bipolar spectrum mood disorders.