Validating affective temperaments in their subaffective and socially positive attributes:: psychometric, clinical and familial data from a French national study
Validating affective temperaments in their subaffective and socially positive attributes:: psychometric, clinical and familial data from a French national study
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DOI：
10.1016/j.jad.2003.12.009
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发表时间：
2005-03-01
影响因子：
6.6
通讯作者：
Hantouche, EG
中科院分区：
文献类型：
--
作者：
Akiskal, HS;Akiskal, K;Hantouche, EG
背景：法国国家EPIDEP研究的主要目标之一是显示系统评估双相II(BP-II)障碍及以后障碍的可行性。在这份报告中，我们重点关注情感气质量表(ATS)在描绘临床和社会期望表达中的这一谱的效用。方法：42名精神科医生在法国四个地区的15个地点3工作，根据DSM IV标准对452例连续的重度抑郁发作(MDE)患者(其中双相I已被移除)进行半结构化诊断。至少在进入研究的一个月后(当急性抑郁阶段减轻时)，他们使用孟菲斯、比萨、巴黎和圣地亚哥的气质评估(TEMPS)的法语版本来评估情感气质。对临床医生评定的高胸腺(HYP-T)、抑郁(DEP-T)和循环胸腺(CyC-T)气质量表和自测的循环胸腺气质(CyC-TSR)进行主成分分析(PCA)。比较单相(UP)重度抑郁障碍患者和BP-II患者在每个气质子量表上的得分，并根据双相情感障碍家族史对整个样本进行细分。结果：PCAS显示每个临床医生评定的子量表都存在一个全局主因子，其相关矩阵的特征值分别为：HYP-T 7.1，DEP-T 6.0，CyC-T 4.7。同样，在自我评级的CYC-TSR上，PCA揭示了一个全局因素(特征值为6.6)。这些因素中的每一个都代表了情感负荷和适应性特征的混合体。临床医生评分与临床症状自评量表评分高度相关(r=0.71)。BP-II组HYP-T和CYC-T评分显著高于UP组(P<；0.001)，UP组显著高于UP组(P<0.05)。最后，在有双相情感家族史的患者中，CYC-T得分显著较高。结论：这些数据支持了所调查的情感气质在面孔、结构、临床和家族史方面的效度。尽管进入EPIDEP研究时抑郁的严重程度是一致的，但在这个庞大的国家队列中，在UP和BP-II患者之间观察到显著的ATS评估差异。结果表明，自评环胸症是可靠的。在传统的抑郁症评估方法中加入情绪性气质--尤其是循环胸腺--，出现了一幅更丰富的情绪障碍画像。更具挑衅性的是，我们的数据揭示了临床康复的情绪障碍患者的社会积极特征。(C)2005 Elsevier B.V.保留所有权利。
Background: One of the major objectives of the French National EPIDEP Study was to show the feasibility of systematic assessment of bipolar II (BP-II) disorder and beyond. In this report We focus on the utility of the affective temperament scales (ATS) in delineating this spectrum in its clinical as well as socially desirable expressions. Methods: Forty-two psychiatrists working in 15 site 3 in four regions of France made semi-structured diagnoses based on DSM IV criteria in a sample of 452 consecutive major depressive episode (MDE) patients (from which bipolar I had been removed). At least I month after entry into the study (when the acute depressive phase had abated), they assessed affective temperaments by using a French version of the precursor of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS). Principal component analyses (PCA) Were conducted on hyperthymic (HYP-T), depressive (DEP-T) and cyclothymic (CYC-T) temperament subscales as assessed by clinicians, and on a self-rated cyclothymic temperament (CYC-TSR). Scores on each of the temperament subscales were compared in unipolar (UP) major depressive disorder versus BP-II patients, and in the entire sample subdivided on the basis of family history of bipolarity. Results: PCAs showed the presence of a global major factor for each clinician-rated subscale With respective eigenvalues of the correlation matrices as follows: 7.1 for HYP-T, 6.0 for DEP-T, and 4.7 for CYC-T. Likewise, on the self-rated CYC-TSR, the PCA revealed one global factor (with an eigenvalue of 6.6). Each of these factors represented a melange of both affect-laden and adaptive traits. The scores obtained on clinician and self-ratings of CYC-T were highly correlated (r = 0.71). The scores of HYP-T and CYC-T were significantly higher in the BP-II group, and DEP-T in the UP group (P < 0.001). Finally, CYC-T scores were significantly higher in patients with a family history of bipolarity. Conclusion: These data uphold the validity of the affective temperaments under investigation in terms of face, construct, clinical and family history validity. Despite uniformity of depressive severity at entry into the EPIDEP study, significant differences on ATS assessment were observed between UP and BP-II patients in this large national cohort. Self-rating of cyclothymia proved reliable. Adding the affective temperaments-in particular, the cyclothymic-to conventional assessment methods of depression, a more enriched portrait of mood disorders emerges. More provocatively, our data reveal socially positive traits in clinically recovering patients with mood disorders. (c) 2005 Elsevier B.V. All rights reserved.