Temperament and impulsivity in bipolar patients with and without obsessive compulsive disorder

Year 2014, Volume: 4 Issue: 3, 103 - 9, 08.10.2014

Faruk Kılıç M. Murat Kuloğlu M. Gürkan Gürok Osman Mermi Murad Atmaca

https://doi.org/10.5455/jmood.20140702014438

Abstract

Objective: The aim of this study is to investigate the dominant affective temperament and the impulsivity of bipolar disorder (BD) patients with and without comorbid obsessive compulsive disorder (OCD) in comparison with healthy controls. Method: The study was conducted among outpatients of the psychiatry clinic of Fırat University Hospital. Thirty patients with the diagnosis of BD with comorbid OCD, 40 patients with the diagnosis of BD without OCD, and 40 healthy controls similar to the study groups in terms of age and gender. The patients and controls were asked to complete a socio-demographic data sheet, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionaire (TEMPS-A), and Barratt Impulsiveness Scale-11 (BIS-11). Patients were also evaluated by Young Mania Rating Scale (YMRS). Results: In both study groups frequencies of dominant depressive, cyclothymic, irritable, and anxious temperament and their scores were significantly higher than those of controls. There was no difference between BD patients with and without OCD comorbidity in respect to their dominant temperaments. The patients scored significantly higher on the BIS-11 total and sub-dimensions than the controls. The scores of attention related with impulsiveness in BD patients with comorbid OCD were significantly higher. Conclusion: In our study we found that BD patients with or without comorbid OCD exhibited differences in some subscores of temperament characteristics and impulsivity when compared with healthy controls.

Keywords

bipolar disorder, obsessive compulsive disorder, temperament, impulsivity

Obsesif kompulsif bozukluğun eşlik ettiği ve etmediği iki uçlu bozukluk hastalarında mizaç ve dürtüsellik

Abstract

Amaç: Bu çalışmada Obsesif Kompulsif Bozukluk (OKB) eşlik eden ve etmeyen iki uçlu bozukluk (İUB) tanılı hastaların baskın mizaç tipleri ile dürtüsellik düzeylerinin kontrol grubuyla karşılaştırılarak değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya Fırat Üniversitesi Hastanesi Psikiyatri Polikliniğine başvuran OKB eşlik eden İUB tanılı 30 hasta, OKB eşlik etmeyen İUB tanılı 40 hasta ile 40 sağlıklı kontrol alındı. Kontrol ve hasta gruplarına sosyodemografik veri formu, Temperament Evaluation of Memphis, Pisa, Paris, San Diego Autoquestionaire (TEMPS-A) mizaç ölçeği, Barratt Dürtüsellik Ölçeği–11 (BDÖ–11) ve hasta grubuna ek olarak Young Mani Derecelendirme Ölçeği (YMDÖ) uygulandı. Bulgular: Her iki hasta grubunun da baskın depresif, siklotimik, irritabl ve anksiyöz mizaç sıklığı ve puanları kontrol grubuna göre anlamlı olarak yüksek bulundu. Baskın mizaç yönünden ise OKB eşlik eden ve etmeyen İUB hastaları arasında anlamlı farklılık yoktu. Hasta gruplarında BDÖ-11 total ve alt boyutları kontrol grubuna göre anlamlı olarak yüksek bulundu. Sonuç: Çalışmamızda, OKB eşlik eden ve etmeyen İUB hastaları ile kontrol grubu arasında mizaç özelliklerinin ve dürtüselliğin alt boyutlarının, bazı alanlarda farklılık gösterdiği tespit edildi.

Keywords

iki uçlu bozukluk, obsesif kompulsif bozukluk, mizaç, dürtüsellik

References

• Krüger S, Baruning P, Cooke RG. Comorbidity of obsessivecompulsive disorder in recovered in patients with bipolar disorder. Bipolar Disord. 2000;2:71-4.
• Simon NM, Otto MW. Anxiety disorder comorbidity in bipolar disorder patients: data from the first 500 participants in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Am J Psychiatry. 2004;161:2222-9.
• Tamam L, Özpoyraz N. Comorbidity of anxiety disorder among patients with bipolar I disorder in remission. Psychopathology. 2002;35:203-9.
• Ünal A, Kuloğlu M, Atmaca M, Geçici Ö, Tezcan E. İki uçlu bozukluğa eşlik eden eksen 1 ve eksen 2 tanıları. Türkiye’de Psikiyatri. 2007;9:18-25.
• Koyuncu A, Tukel R, Ozyildirim I, Meteris H, Yazici O. Impact of obsessive compulsive disorder comorbidity on the sociodemographic and clinical features of patients with bipolar disorder. Compr Psychiatry. 2010;51:293-7.
• Pedro VSM, Kapczinski NS, Kapczinski F. Correlates and impact of obsessive-compulsive comorbidity in bipolar disorder. Compr Psychiatry. 2010;51:353-6.
• Karataş KS, Güler J, Hariri A. Bipolar Disorder and Obsessive Compulsive Disorder Comorbidity: Three Case Reports. J Mood Disord. 2013;3:33-6.
• Akiskal HS, Hirschfeld MA, Yerevanian BI. The relationship of personality to affective disorders. Arch Gen Psychiatry. 1983;40:801-10.
• Köse S. A psychobiological model of temperament and character: TCI. Yeni Symposium. 2003;41:86-97.
• Goodwin FK, Jamison KR. Manic-depressive Illness. New York: Oxford University Press, 1990.
• Akiskal HS, Mallya G. Criteria for the soft bipolar spectrum treatment implications. Psychopharmacol Bull. 1987;23:68-73.
• Moeller FG, Barratt ES, Dougherty DM, Scmitz JM, Swann AC. Psychiatric aspects of impulsivity. Am J Psychiatry. 2001;158:1783-93.
• Peluso MA, Hatch JP, Glahn DC, Monkul ES, Sanches M, Najt P, Bowden CL, Barratt ES, Soares JC. Trait impulsivity in patients with mood disorders. J Affect Disord. 2007;100:227-31.
• Swann AC, Anderson JC, Dougherty DM, Moeller FG. Measurement of inter-episode impulsivity in bipolar disorder. Psychiatry Res. 2001;101:195-7.
• Swann AC, Dougherty DM, Pazzaglia PJ, Pham M, Moeller FG. Impulsivity: a link between bipolar disorder and substance abuse. Bipolar Disord 2004;6:204-12.
• Matsuo K, Nielsen N, Nicoletti MA, Hatch JP, Monkul ES, Watanabe Y. Anterior genu corpus callosum and impulsivity in suicidal patients with bipolar disorder. Neurosci Lett. 2010;469:75-80.
• Güleç H, Tamam L, Usta H, Saygılı İ, Güleç MY, Zengin M, Karakuş G. İki uçlu bozuklukta dürtüsellik. Anatolian Journal of Psychiatry. 2009;10:198-203.
• Chamberlain SR, Blackwell AD, Fineberg NA, Robbins TW, Sahakian BJ. The neuropsychology of obsessive-compulsive disorder: the importance of failures in cognitive and behavioural inhibition as candidate endophenotypic markers. Neurosci Biobehav Rev. 2005;29:399-419.
• First MB, Spitzer RL, Gibbon M, Williams Janet BW. Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Clinical Version. American Psychiatric Press Inc, Washington D.C. 1997.
• Çorapçıoğlu A, Aydemir Ö, Yıldız M. DSM-IV Eksen-I bozuklukları için yapılandırılmış klinik görüşmenin Türkçe’ye uygulanması ve güvenilirlik çalışması. İlaç ve Tedavi Dergisi. 1999;12:233-6.
• Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania:Reliability, validity, and sensitivity. Br J Psychiatry. 1978;133:429-35.
• Karadağ F. Young mani değerlendirme ölçeğinin Türkçe çevirisinin güvenilirlik ve geçerlilik çalışması. Turk Psikiyatri Derg. 2002;13:107-114.
• Akiskal HS. Akiskal KK. Haykal RF. Manning JS. Connor PD. TEMPS-A: progress towards validation of a self-rated clinical version of the temperament evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire. J Affect Disord. 2005;85:3-16.
• Vahip S, Kesebir S, Alkan M. Affective temperaments in clinicallywell subjects in Turkey: initial psychometric data on the TEMPS-A. J Affect Disord. 2005;85:113-25.
• Patton JH, Stanford MS, Barratt ES. Factor structure of the Barratt impulsiveness scale. J Clin Psychol. 1995;51:768-74.
• Güleç H, Tamam L, Güleç MY, Turhan M, Karakuş G, Stanford MS. Psychometric properties of the Turkish version of the Barratt Impulsiveness Scale-11. Klinik Psikofarmakoloji Bülteni. 2008;18:245-52.
• Sayın A, Aslan S. Duygudurum bozuklukları ile huy, karakter ve kişilik ilişkisi. Turk Psikiyatri Derg. 2005;16:276-83.
• Kesebir S, Vahip S, Akdeniz F, Yüncü Z. İki uçlu bozuklukta mizaç ile klinik özelliklerin ilişkisi. Turk Psikiyatri Derg. 2005;16:164-9.
• Akiskal HS. The Temperamental foundations of affective disorders. Mundt C (editor). Interpersonal Origin and Course of Affective Disorders. London: Gaskell. Royal College of Psychiatrists. 1996:3
• Akiskal HS. Cyclotimic, hypertimic and depressive temperaments as subaffective variants of mood disorders. Tasman A, Riba MB (editors): APA Review. Washington DC: American Psychiartic Pres. 1992:43-62.
• Akiskal HS, Khani MK, Scott-Strauss A. Cyclothymic temperamental disorders. Psychiatr Clin North Am. 1979;2:527-54.
• Hirschfeld RMA, Klerman GL. Personality attributes and affective disorders. Am J Psychiatry. 1979;136:67-70.
• Akdeniz F, Kesebir S, Vahip S, Gönül AS. Duygudurum bozuklukları ile mizaç arasında ilişki var mı? Turk Psikiyatri Derg. 2004;15:183
• Kesebir S, Vahip S, Akdeniz F. Affective temperaments as measured by TEMPS-A in patients with bipolar I disorder and their first degree relatives: a controlled study. J Affect Disord. 2005;85:127
• Henry C, Lacoste J, Bellivier F, Verdoux H, Bourgeous ML, Leboyer M. Temperament in bipolar illness: impact on prognosis. J Affect Disord. 1999;56:103-8.
• Krüger S, Cooke RG, Hasey GM. Comorbidity of obsessive compulsive disorder in bipolar disorder. J Affect Disord. 1995;34:117-20.
• Perugi G, Akiskal HS, Ramaciotti S. Depressive comorbidity of panic, social phobic, and obsessive-compulsive disorders re-examined: Is there a bipolar II connection? Psychiatr Res. 1999;33:53-61.
• Fıstıkçı N, Hacıoğlu M, Erek Ş, Tabo A, Saatçıoğlu Ö. İki uçlu Bozukluğu Olan ve Olmayan Obsesif Kompulsif Bozukluk Hastalarının Klinik ve Afektif Mizaç Özelliklerinin Karşılaştırılması. Marmara Medical Journal. 2012;25:26-31.
• Tamam L. Bipolar Bozukluk İle Anksiyete Bozukluğu Birlikteliği: Bir Gözden Geçirme. Turk Psikiyatri Derg. 2007;18:59-71.
• Swann AC, Pazzaglia P, Nicholls A, Dougherty DM, Moeller FG. Impulsivity and phase of illnes in bipolar disorder. J Affect Disord. 2003;73:105-11.
• Dolenc B, Sprah L. Temperaments and impulsivity in bipolar disorder. Rev Psychol. 2010;17:2.