The Association Between Suicide Risk and Affective Temperaments in First-Episode and Neuroleptic-Naïve Major Depressive Disorder

Background Suicide risk is associated with depression. Affective temperaments may play a role in this risk. We explored the relationship between affective temperaments and suicide and identified some traits that can predict suicide risk in depression. Methods We analyzed the results of Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto-questionnaire (TEMPS-A) in 284 participants recruited from a psychiatric clinic and the community in Beijing and compared the subscale scores (cyclothymic, dysthymic, anxious, irritable and hyperthymic) among major depressive disorder (MDD) versus the general population as well as depressive patients with versus without suicide risk, using student’s test, Chi-square test, rank sum test, multivariable regression modeling and receiver operating characteristic (ROC) analysis. Results The incidence of suicidal risk in depressive subjects was 47.62% (80/168). Being unmarried (P<0.001), unemployment (P=0.007) and temperaments of dysthymic, cyclothymic, anxious, and irritable scores (all P<0.05) were significantly more prevalent in depressive patients than in the general population. A young age (P<0.001), female sex (P=0.037), being unmarried (P=0.001), more severe depression (P<0.001), and dysthymic, anxious and cyclothymic temperament (all P<0.05) were significantly more prevalent in depressive disorder patients with suicide risk than in those without suicide risk. The logistic regression analysis showed that younger age (OR=0.937, 95% CI 0.905~0.970), female sex (OR=2.606, 95% CI 1.142~5.948), more severe depression (OR=1.145, 95% CI 1.063~1.234), cyclothymic temperament (OR=1.275, 95% CI 1.102~1.475) and dysthymic temperament (OR=1.265, 95% CI 1.037~1.542) were all independently associated with high suicidal risk in first-episode major depressive patients (P<0.05). By ROC analysis, the area under the compound factor (age, sex, HAMD score without the 3rd item, cyclothymic and dysthymic temperament) was 0.853 (95% CI 0.790~0.903). Conclusion The suicide rate in first-episode neuroleptic-naïve major depressive disorder (MDD) subjects was higher than we thought. Temperament traits differ between the general population and those with major depressive disorder. Major depressive disorder subjects with much more severe depressive symptoms and cyclothymic or dysthymic temperament were at high risk of suicide. Compound factors (age, sex, HAMD score without the 3rd item, cyclothymic and dysthymic temperament score) could be predictors of suicide risk in the clinic.

Problematic smartphone use and affective temperaments among Lebanese young adults: scale validation and mediating role of self-esteem

Background Adults all over the world face serious issues from problematic smartphone use (PSU). It influences them negatively on a cognitive, behavioral, and emotional level, as well as on their tendencies and well-being. In Lebanon, the prevalence of PSU was shown to be 20.2% within the adult population, specifically with young adults (18–34 years old). This study investigates the validity and reliability of the Smartphone Addiction Scale (SAS) Arabic version. In addition, this study evaluates the association between PSU and affective temperaments and the mediating role of self-esteem in this association. Method A cross-sectional study was carried out between August and September 2020, using a sample of community-dwelling participants aged 18 to 29 years. The Smartphone Addiction Scale—Short Version was used to evaluate smartphone addiction among adolescents and adults. The five different temperaments of the patients were assessed by using the Affective temperament Scale (TEMPS‐A). The Rosenberg Self-Esteem Scale was used to evaluate self-esteem. Results 461 participants were included in this study. All items of the SAS were extracted and yielded a one-factor solution with Eigenvalues > 1 (variance explained = 49.96%; αCronbach = 0.886). The confirmatory analysis results consolidated those obtained from the factor analysis. Higher depressive temperament (B = 0.46) was significantly associated with more smartphone addiction, whereas higher self-esteem (B = − 0.28) was significantly associated with less smartphone addiction. Self-esteem was found to mediate the association between depressive and hyperthymic temperaments with smartphone addiction. Conclusion This study added a better understanding of the high smartphone addiction rate among adults in Lebanon. It confirms the association between affective temperaments and PSU through the mediating effect of self-esteem on Lebanese adults.

Predictive factors of quality of life in temporal and extratemporal lobe epilepsy: association with affective temperament profiles and psychiatric comorbidities

ABSTRACT Background: Investigating predictive factors of reduced quality of life (QOL) of patients and their association with focal epilepsy can improve management and treatment strategies. Objective: This study aimed to investigate the relationship between affective temperaments, depression, anxiety, disease characteristics, and QOL and to explore the predictors of QOL in patients with temporal lobe epilepsy (TLE) and extratemporal lobe epilepsy (ETLE). Methods: A total of 50 patients with TLE, 51 patients with ETLE, and 70 controls were enrolled. Affective temperaments were evaluated using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A). QOL was assessed by the Short-Form Health Survey (SF-36). Beck Depression Inventory and Beck Anxiety Inventory were used to explore depression and anxiety severity, respectively. Results: Compared with the controls, patients with TLE and ETLE had significantly higher scores on all TEMPS-A scales, except on hyperthymic temperament. All the SF-36 subscale scores were lower in the TLE and ETLE groups. Linear regression analysis revealed that depressive symptoms, anxiety, depressive and irritable temperament, and seizure frequency were significant predictors of QOL in TLE. Patients with ETLE with temperamental disturbances, depressive symptoms, and polytherapy had a poorer QOL. Conclusions: Affective temperaments, psychiatric disorders, and clinical factors may predict impaired QOL in patients with TLE and ETLE. Further studies are needed to identify predictors of QOL in various epilepsy subtypes.

Genetic underpinnings of affective temperaments: a pilot GWAS investigation identifies a new genome-wide significant SNP for anxious temperament in ADGRB3 gene

Although recently a large-sample GWASs identified significant loci in the background of depression, the heterogeneity of the depressive phenotype and the lack of accurate phenotyping hinders applicability of findings. We carried out a pilot GWAS with in-depth phenotyping of affective temperaments, considered as subclinical manifestations and high-risk states for affective disorders, in a general population sample of European origin. Affective temperaments were measured by TEMPS-A. SNP-level association was assessed by linear regression models, assuming an additive genetic effect, using PLINK1.9. Gender, age, the first ten principal components (PCs) and the other four temperaments were included in the regression models as covariates. SNP-level relevances (p-values) were aggregated to gene level using the PEGASUS method1. In SNP-based tests, a Bonferroni-corrected significance threshold of p ≤ 5.0 × 10−8 and a suggestive significance threshold of p ≤ 1.0 × 10−5, whereas in gene-based tests a Bonferroni-corrected significance of 2.0 × 10−6 and a suggestive significance of p ≤ 4.0 × 10−4 was established. To explore known functional effects of the most significant SNPs, FUMA v1.3.5 was used. We identified 1 significant and 21 suggestively significant SNPs in ADGRB3, expressed in the brain, for anxious temperament. Several other brain-relevant SNPs and genes emerged at suggestive significance for the other temperaments. Functional analyses reflecting effect on gene expression and participation in chromatin interactions also pointed to several genes expressed in the brain with potentially relevant phenotypes regulated by our top SNPs. Our findings need to be tested in larger GWA studies and candidate gene analyses in well-phenotyped samples in relation to affective disorders and related phenotypes.