ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - Role of Temperament in Mixed Depressive and Psychotic Mania: Data on 1090 patients


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ASPOFAFF :: Journal - Volume 1 :: Issue 2 :: Vol 1 - Iss 2 - Short Communication - Role of Temperament in Mixed Depressive and Psychotic Mania: Data on 1090 patients – “EPIMAN-II”

Vol 1 - Iss 2 - Short Communication - Role of Temperament in Mixed Depressive and Psychotic Mania: Data on 1090 patients – “EPIMAN-II” #45

Role of Temperament in Mixed Depressive and Psychotic Mania: Data on 1090 patients – “EPIMAN-II” Akiskal HS1, Hantouche EG2, Azorin JM3, Lancrenon S4, Châtenet-Duchêne L5 1International Mood Center, UCSD, San Diego 2 Mood Center, Université Paris VI, Hôpital Pitié-Salpêtrière, Paris 3 Hôpital Ste Marguerite, Marsielle 4 Sylia-Stat, Antomy 5 CNS Department Sanofi-Synthelabo, Le Plessis Robinson-France Following the EPIMAN study (Akiskal et al, 1998), a new French study (EPIMAN-II Thousand) was initiated in December 2000 with the objective of including 1000 patients with acute mania. In this report, data are focused on the influence of affective temperaments on the clinical picture of mania. Method: “EPIMAN-II Thousand” is a national multi-site collaborative study dedicated to the clinical sub-types of mania. It involved training 317 French psychiatrists working in different sites representative of France. The study actually succeeded in recruiting 1090 cases admitted for acute mania (DSM-IV criteria). To minimize any “state contamination” the full self-rated version of Affective Temperament Scales (4 scales adapted by Hantouche et al, 2001) was filled out by patients after acute mania abated. Mixed mania was defined by the presence of 2 depressive symptoms or more. Results: Compared to pure mania, mixed mania was characterized by augmented global scores on: Cyclothymic-Temp. (12,5 vs 9,1), Depressive-Temp. (8,9 vs 6,9) and Irritable-Temp. (7,3 vs 5,9) (all p=0,0001). On the contrary, the score on Hyperthymic-Temp. was higher in pure mania (13,1 vs12,0, p=0,001). When separating sub-groups according to psychotic features, the highest score on Hyperthymic-Temp was obtained in cases with mood-congruent psychotic features (13,5 vs 12,4 in non psychotic mania, p<0,05). High score on Irritable-Temp. characterized the sub-group with mood-incongruent psychotic features (7,2 vs. 6,1 in non psychotic mania, p<0,05). Conclusion: Complex phenomenology of acute mania could be related to the intimate interweaving with of affective temperament. Mood-incongruent psychotic features could be best explained by the presence of a high level of long-standing irritable traits. Bibliography: Akiskal HS et al. Gender, temperament, and the clinical picture in dysphoric mixed mania: findings from EPIMAN study. J Affect Disord 1998; 50: 175-86. Hantouche EG et al. Clinical assessment of affective temperaments: full version of self-rating. L’ Encéphale 2001 27 (S1): 24-30. Funding source: unrestricted grant from Sanofi-Aventis

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