Temperaments characterized by high activity appear to be protective of major mood episodes in offspring at high genetic risk and could reflect specific preventive targets, according to results from a study published in the Journal of Affective Disorders. In addition, although temperament characteristics and self-esteem do not appear to be predictive of onset of incident major depression, they do appear to be affected negatively early in the course of emergent bipolar disorder and may be important targets for early intervention.
Researchers conducted a prospective longitudinal study, examining data from the Canadian Flourish Prospective Offspring Study. The cohort included 285 children who had a parent with bipolar disorder and who were at high risk for bipolar disorder. Study participants were assessed clinically using the KSADS-PL (Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime) and SADS-L (Schedule for Affective Disorders and Schizophrenia-Lifetime) interview tools. Self-esteem and temperament characteristics were measured using other self-reported scales.
After statistical analysis, investigators found that self-esteem and temperament characteristics, emotionality and shyness, were not associated with the onset of a major depressive episode. However, precursor emotionality and shyness activity reduced the incident hazard of a major depressive mood episode (hazard ratio [HR], 0.51; 95% CI, 0.27-0.98; P =.0448). In addition, researchers reported that after a major depressive episode, sociability (P =.0001), activity (P =.0001), and self-esteem (P =.001) measures decreased, and emotionality (P =.0289) and shyness (P =.0196) scores increased.
Primary study limitations included the self-reported nature of psychological measures and other confounding factors.
“These findings underscore the importance of accounting for prior major mood episodes and other clinical features when studying the effects of temperament and self-esteem on major mood disorders,” the researchers wrote. They also noted that these findings indicate a need for prevention of incident major mood episodes, as psychological factors after these events can contribute to the overall burden of illness and worsen over time.
Further studies are needed to fully understand the links between temperament characteristics, self-esteem, and mood disorders.
Goodday SM, Preisig M, Gholamrezaee M, Grof P, Duffy A. Temperament and self-esteem in high-risk offspring of bipolar parents: vulnerability and scar effects. J Affect Disord. 2019;243:209-215.