• mania
• functional outcome
• bipolar disorder
• affective temperaments

Background: Affective temperaments have been shown to impact on the clinical manifestation and on the course of Bipolar Disorder (BD); in the present study we investigated their influence on clinical features and functional outcome of mania.
Method: In a naturalistic, multicenter, national Study, a sample of 194 BD-I patients with DSM-IV-TR manic episode underwent a comprehensive evaluation including the Young Mania Rating Scale (YMRS), the Montgomery and Asberg Depression Rating Scale (MADRS), the Functioning Assessment Short Test (FAST), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego brief-version (briefTEMPS-M) scale, the Childhood Trauma Questionnaire (CTQ) and the Clinical Global Impression Scale-Bipolar Illness (CGI-BP). Factorial, correlation and comparative analyses were conducted on different temperamental subtypes based on the briefTEMPS-M profile.
Results: Depressive, cyclothymic, irritable and anxious temperaments resulted significantly correlated with each other. On the contrary, hyperthymic temperament scores were not correlated with the other temperamental dimensions, with the exception of irritable temperament. The factorial analysis of the briefTEMPS-M sub-scales total scores allowed the extraction of 2 factors: the Cyclothymic-Depressive-Anxious (Cyclo-Dep-Anx) and the Hyperthymic. No differences between the two temperamental subtypes were observed in lifetime comorbidity and in demographic-clinical characteristics, with the exception of a higher family history for BD in Hyperthymic group. At final evaluation the Hyperthymic patients showed a greater functional outcome, as measured by FAST sub-scales, compared to Cyclo-Dep-Anx patients. On the other side, this latter group was associated with greater depressive symptoms and history of childhood emotional neglect an abuse compared to Hyperthymic group.
Conclusions: Our results support the view that affective temperaments influence the course of mania. In particular, in manic patients the presence of Hyperthymic temperament is associated with lower rates of depressive symptoms and childhood trauma and with a better functional outcome.