TEMPS-A and long-term lithium response: positive correlation with hyperthymic temperament

Lithium is still regarded as a cornerstone for the long-term treatment of bipolar disorder. The best response to lithium is associated with clinical features of episodic clinical course, complete remission, bipolar family history and low psychiatric comorbidity. However, a specific personality profile for the best lithium response was not estimated so far. Such a possibility occurred with an advent of temperament scale for bipolar disorder and of an ability to quantitatively assess lithium prophylactic response.

The study was performed on 71 patients with bipolar mood disorder (21 males, 50 females), aged 31-82 (59±12) years, which have been treated with lithium carbonate for at least 5 years (5-37 years, mean 15 years). In all patients, the assessment of five temperaments of TEMPS-A scale (depressive, cyclothymic, hyperthymic, irritable and anxious) was done, and correlated with the quality of lithium prophylaxis according to Alda scale.

The mean scores for five temperaments of TEMPS-A were not significantly different in male and female patients. The response to lithium correlated significantly positively with hyperthymic temperament score (r=0.31, p=0.009), and negatively with anxiety (r=-0.27, p=0.022), cyclothymic (r=-0.26, p=0.032), and depressive (r=-0.23, p=0.052) temperaments scores.

Relatively small number of patients.

The main finding of the study is an association of lithium response with hyperthymic temperament. This positive correlation as well as other negative correlations between lithium response and TEMPS-A temperaments are discussed in view of clinical and genetic findings in bipolar patients.