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Nord J Psychiatry. 2018 Jan;72(1):63-71. doi: 10.1080/08039488.2017.1385851. Epub 2017 Oct 12.

Irritable temperament and lifetime psychotic symptoms as predictors of anxiety symptoms in bipolar disorder.

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a Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry , University of Genoa , Genoa , Italy.
b Sorbonne Paris Cité, UMR-S 1144 , Université Paris Diderot , Paris , France.
c Pôle de Psychiatrie et de Médecine Addictologique , AP-HP, GH Saint-Louis - Lariboisière - F. Widal , Paris , France.
d Department of Neuroscience , Suicide Prevention Center, Sant'Andrea Hospital, University of Rome , Rome , Italy.



Affective temperaments, hopelessness, alexithymia, and anxiety/agitation symptoms may play a significant role in the psychopathological characteristics of bipolar disorder (BD). Here, we aimed to investigate the eventual association between the mentioned explanatory variables and anxiety/agitation symptoms in BD.


We recruited at the Section of Psychiatry, Department of Neuroscience, University of Genoa (Italy), 92 BD inpatients having a mean age of 52 (±13.8) years. Participants were assessed using specific psychometric instruments. Anxiety/agitation symptoms have been evaluated using the 11-item of the Beck Depression Inventory II (BDI-II).


Overall, 53.8% of participants presented with anxiety/agitation symptoms and 46.2% without. The two groups significantly differed about socio-economic status, lifetime psychotic symptoms, and residual depressive symptoms between episodes. Anxiety/agitation symptoms significantly correlated with irritable affective temperament (r = 0.407; p = .01), hopelessness (r = 0.541; p ≤ .001), difficulty identifying feelings (r = 0.440; p ≤ .001), difficulty describing feelings (r = 0.437; p ≤ .001), and externally oriented-thinking (r = 0.393; p ≤ .001). After multivariate analyses, irritable affective temperament (OR = 2.457, p ≤ .01) and less lifetime psychotic symptoms (OR = 0.007, p ≤ .05) remained the only significant variables associated with anxiety/agitation symptoms.


The generalization of the main findings is limited by the small sample size and cross-sectional study design. Nevertheless, our results suggest that the careful assessment of affective temperaments and psychotic symptoms may help to early identify BD patients suffering from anxiety/agitation symptoms and may allow to perform targeted interventions in the clinical practice.


Bipolar disorder; alexithymia; anxiety/agitation symptoms; difficulty describing feelings; difficulty identifying feelings; externally oriented-thinking; hopelessness; irritable affective temperament; lifetime psychotic symptoms

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