[Tools for clinical evaluation of affective temperaments]

The authors argue from an "adult" perspective, that clinically ascertained affective dysregulations are prevalent in the prebipolar history. This hypothesis is based: 1) on early age of onset; 2) gender ratio; 3) high propensity to mood switching under antidepressant treatment; 4) high rate of recurrence; 5) family affective loading and; 6) the frequent superposition of major episodes on affective temperamental dysregulation (prominence of mood lability and explosive anger: indicators of mixed states). The authors submit that affective temperaments (cyclothymic, hyperthymic and dysthymic) represent putative developmental pathways to bipolarity. A french version of the semi-structured interview and self-assessment of affective temperaments had been constructed by the authors. The french version of these psychometric tools is presented in this chapter. The authors hoped that current knowledge and new research in the domain of affective temperaments will encourage clinicians to further understanding the manic-depressive illness and to make early detection of different clinical expressions of bipolarity. More clinical sophistication is needed to go beyond the classical "diagnostic" instruments and artificial classifications (as in DSM IV) and to delineate the psycho-biological pathways to bipolarity.