Relationship between hostility and subjective sleep quality.

While hostility and sleep disturbance are the potential risk factors for health problems and disease, few studies have examined the relationship between the two factors. The present study was performed to investigate the relationship between hostility and sleep problems assessed both subjectively and objectively in a nonclinical sample. Sixty-one healthy subjects were enrolled in this study. Hostility was measured according to the Cook-Medley hostility scale. Subjective sleep quality was evaluated according to the global score of the Pittsburgh Sleep Quality Index. Objective sleep was evaluated using actigraphy. A multiple regression analysis revealed that a higher level of hostility was significantly associated with the global score of the Pittsburgh Sleep Quality Index and that a higher level of depression was not associated with the global score of the Pittsburgh Sleep Quality Index. Objective sleep measures were not found to be associated with hostility. Confirming the robust relationship between poor sleep and hostility would have several important treatment implications for preventing health problems.

Type A behavior pattern: Bortner scale vs. Japanese-original questionnaires.

BACKGROUND: Type A behavior pattern (TABP) has been regarded as a putative risk factor for coronary heart disease and recent studies from our group suggest that TABP individuals, identified via the Bortner scale whose validity had been confirmed by structured interviews, may have a greater tendency towards hyperthymic temperament, shorter sleep time and shorter snooze time. Since the Bortner scale was developed in USA and may reflect western culture, it is necessary to reconfirm our findings using a Japanese questionnaire such as Coronary-prone Type Scale for Japanese (CTS) and Kwansei Gakuin's daily life questionnaire (KG questionnaire). METHODS: Fifty healthy subjects were assessed for TABP using the Bortner scale, as well as the CTS and KG questionnaires. Hyperthymic temperament was assessed via the Japanese standardized version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire (TEMPS-A), while sleep time and snooze time were measured by actigraphy. RESULTS: Both CTS and KG questionnaire scores were significantly and positively associated with the Bortner scale scores. Although CTS and KG scores were significantly and positively associated with hyperthymic temperament scores, none were associated with sleep time or snooze time. LIMITATIONS: The number of subjects was relatively small. CONCLUSIONS: The findings suggest that Japanese questionnaires such as CTS and KG questionnaires are valid as measures of TABP. Moreover, the association between TABP and hyperthymic temperament was reconfirmed by both CTS and KG questionnaires, whereas the association between TABP and sleep pattern was not. As such, the present findings provide supportive evidence about the usefulness of CTS and KG questionnaires.

Aripiprazole may be free from tachyphylaxis: preliminary findings.

Loss of antipsychotic efficacy (tachyphylaxis), possibly linked to an increase in D2 receptor number and sensitivity, is a significant impediment to treatment in chronic schizophrenia patients. Animal studies, however, suggest that aripiprazole may be free from tachyphylaxis. The aim of the present study was to investigate this hypothesis. In this preliminary study, aripiprazole-treated patients were retrospectively investigated for the presence or absence of tachyphylaxis. Clinical Global Impression-Improvement (CGI-I) scores did not significantly change and there was no significant association of CGI scores with fixed dose duration. This suggests that aripiprazole may be free from tachyphylaxis.

Is serotonergic function associated with the antidepressant effects of modified-electroconvulsive therapy?

BACKGROUND: The effect of modified-electroconvulsive therapy (m-ECT) on central serotonergic function has not been sufficiently investigated. The aim of the present study is to investigate this effect via the neuroendocrine challenge test. METHODS: Sixteen inpatients (9 men and 7 women) with major depressive disorder who were receiving m-ECT at our university hospital were recruited. A neuroendocrine challenge test to estimate central serotonergic function was performed both before and after m-ECT treatment. RESULTS: On the whole, depressive symptoms significantly improved, but the improvement was not associated with changes in serotonergic function. LIMITATIONS: The study was open-labeled and performed with a small number of subjects and no control group. CONCLUSION: Serotonergic function may not be associated with the antidepressant effects of ECT.

Bipolar temperaments and light.

BACKGROUND: Converging lines of evidence have established a relationship between exposure to ambient light and both mood state and mood disorders. In view of the association between mood disorder and affective disposition, in this study, the relationship between temperament (depressive, cyclothymic, hyperthymic, irritable and anxious) and daily light exposure was closely examined. METHODS: Fifty-six subjects completed the Japanese standardized version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-auto questionnaire version (TEMPS-A) and illuminance of daytime using actigraphy. RESULTS: Cyclothymic temperament scores were significantly and negatively associated with illuminance of daytime whereas hyperthymic temperament scores were significantly and positively associated with illuminance of daytime. LIMITATIONS: Sample size was relatively small and they were only healthy subjects and no patients. CONCLUSIONS: The findings suggest that illuminance of daytime may be related to both cyclothymic and hyperthymic temperaments but that the associations lie in opposite directions. If this is the case, it seems important to consider individual patients' temperaments when light therapy is used to treat their depressive episode. Further studies are required to determine why and how these temperaments are associated with illuminance.

Effect of temperaments on quality of life and social adaptation in depressive patients with mood disorder.

AIMS: The aim of this study was to investigate the effects of temperament on quality of life and social adaptation in depressive patients with mood disorder. METHODS: Forty-six consecutive depressive outpatients were investigated by using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version, the Munich Personality Test, the World Health Organization Quality of Life 26 (WHO QOL 26), and the Social Adaptation Self-evaluation Scale (SASS). The unpaired t-test, Pearson's r and multiple regression analysis were used to assess three variables (age, the number of temperaments and/or personality types, and Hamilton Depression Rating Scale scores) as independent variables with the scores of WHO QOL 26 and SASS as the dependent variables. RESULTS: The number of temperaments and/or personalities and Hamilton Depression Rating Scale scores were significantly and negatively associated with WHO QOL 26 scores while only the number of temperaments and/or personalities was significantly and negatively associated with SASS scores. CONCLUSIONS: The findings suggest that the combination of temperaments and/or personality types assessed with the Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version and the Munich Personality Test may worsen both quality of life and social adaptation and that some temperaments and/or personality types in combination may be subclinical manifestations of mood disorders.

Type A behavior pattern and hyperthymic temperament: possible association with bipolar IV disorder.

BACKGROUND: Type A behavior pattern (TABP) has traditionally been reported to be associated with coronary heart disease and, more recently, several researchers have examined its association with depression and bipolar disorder. According to Akiskal and Pinto (1999), there are 2 subtypes of bipolar spectrum which are not associated with manic or hypomanic state. These are bipolar II1/2 (depression in those who have cyclothymic temperament) and bipolar IV (depression in those who have hyperthymic temperament). Our hypothesis is that individuals with hyperthymic temperament may have a tendency towards TABP. OBJECTIVES: The purposes of the present study are to investigate the association between TABP and hyperthymic temperament and to determine other biological factors associated with TABP. METHODS: Fifty healthy subjects were assessed for TABP and hyperthymic temperament by self-rating scales, daily activity, sleep time and illuminance by actigraphy, and central serotonergic function via the neuroendocrine challenge test. Serum brain-derived neurotrophic factor (BDNF) levels were also measured. RESULTS: Stepwise regression analysis indicated that hyperthymic temperament score was positively associated with TABP scores and both sleep time and snooze time were negatively associated with TABP scores. BDNF levels were not associated with TABP scores. CONCLUSIONS: These findings suggest that individuals with hyperthymic temperament may have a tendency towards TABP, and TABP persons may have short sleep time and short snooze time. Although further studies are required to investigate the association between TABP and affective disorders, the present findings clearly indicate the association between TABP and hyperthymic temperament, which may be associated with bipolar IV disorder. Taking TABP as a risk factor of cardiovascular events into consideration, this association between TABP and bipolar IV disorder may account for the well-known cardiovascular mortality in bipolar disorder.

Infrared radiation has potential antidepressant and anxiolytic effects in animal model of depression and anxiety.

BACKGROUND: Bright light therapy has been shown to have antidepressant and anxiolytic effects in humans. OBJECTIVE: The antidepressant and anxiolytic effects of infrared radiation were evaluated using an experimental animal model. METHODS: Rats were randomly assigned to either an acutely or chronically exposed infrared radiation group or to a nonexposed control group. Acutely exposed rats were treated with an infrared radiation machine for one session, whereas chronically exposed animals were treated with an infrared radiation for 10 sessions. Control group rats were exposed to the sound of the infrared radiation machine as a sham treatment. After infrared radiation or control exposure, rats underwent behavioral evaluation, including elevated plus maze test, light/dark box, and forced swim test. RESULTS: Chronic infrared radiation exposure decreased indicators of depression- and anxiety-like behavior. No significant effect on general locomotor activity was observed. The number of BrdU-positive cells in CA1 of the hippocampus was significantly increased in both acutely and chronically exposed infrared radiation groups compared with the control group. CONCLUSIONS: These results indicate that chronic infrared radiation might produce antidepressant- and anxiolytic-like effects.

Cyclothymic and hyperthymic temperaments may predict bipolarity in major depressive disorder: a supportive evidence for bipolar II1/2 and IV.

BACKGROUND: The concept of soft bipolar spectrum has not been fully confirmed. The aim of the present study is to investigate the validity of bipolar II1/2 and IV concept. METHODS: The subjects were 46 consecutive outpatients. The individual temperament of each patient was recorded using the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A). The operational definition of bipolar II1/2 was those who had depression with cyclothymic temperament and that of bipolar IV was those who had depression with hyperthymic temperament. Finally, drug responses were investigated. RESULTS: DSM-IV-TR diagnoses were bipolar I (N=1), bipolar II (N=9), major depressive disorder (N=34) and depressive disorder not otherwise specified (N=2). Excluding one bipolar I patient, who had both cyclothymic and hyperthymic temperaments, patients with bipolar II1/2 (N=32) and IV (N=13) as well as bipolar II (N=9) were classified into the soft bipolar spectrum, although there was considerable overlap. The categorization of soft bipolar spectrum and unipolar depression significantly predicted depressive, cyclothymic, irritable, and anxious temperaments. Moreover, soft bipolar spectrum patients with lithium treatment were significantly more in remission than those without lithium treatment. In addition, more of those with selective serotonin reuptake inhibitors (SSRIs) had a significant tendency to lower remission than those without SSRIs. LIMITATIONS: This is a cross-sectional study with a relatively small number of subjects. CONCLUSIONS: The present findings suggest that cyclothymic and hyperthymic temperaments may predict bipolarity, and the validity of bipolar II1/2 and IV concept is supported.

Biological aspect of hyperthymic temperament: light, sleep, and serotonin.

RATIONALE: Hyperthymic temperament is one of several premorbid temperaments putatively associated with bipolar disorder. Several reports suggest that depressive patients with hyperthymic temperament may belong to the proposed soft bipolar spectrum. OBJECTIVES: To investigate biological aspects of hyperthymic temperament, the present study examined daily activity, sleep time, central serotonergic function, and other relevant variables in relation to hyperthymic temperament in healthy subjects. METHODS: Fifty six healthy subjects were monitored via the actigraphy system to measure daily total activity, sleep time, and illuminance. A neuroendocrine challenge test was performed to estimate central serotonergic function. RESULTS: Multiple regression analysis revealed that higher illuminance of daytime, greater fluctuation in sleep time, and lower central serotonergic function significantly and independently predicted hyperthymic temperament scores. CONCLUSIONS: The present findings suggest that light, sleep, and serotonin are crucial factors in understanding hyperthymic temperament, which may be common to bipolar disorder.

Association between affective temperaments and brain-derived neurotrophic factor, glycogen synthase kinase 3ß and Wnt signaling pathway gene polymorphisms in healthy subjects.

BACKGROUND: There is increased attention towards elucidating genetic factors that underlie both psychiatric diseases as well as healthy psychological phenomena. Recent evidence suggests that temperamental traits, including affective temperaments, are heritable and associated with genetic polymorphisms. Genetic research examining affective temperaments using the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) may therefore elucidate the concept of a spectrum of mood disorders and the genetic relationship between affective temperaments and mood disorders. The purpose of this study was to examine the association between brain-derived neurotrophic factor (BDNF), glycogen synthase kinase 3ß(GSK3ß) and Wnt signaling pathway (Wnt) gene polymorphisms and affective temperaments in non-clinical Japanese subjects, as measured by TEMPS-A. METHODS: 44 healthy Japanese subjects were recruited through our university hospital and completed the TEMPS-A. We genotyped three SNPs (single nucleotide polymorphisms) from the BDNF, GSK3ßand Wnt genes in order to test the relationship between these gene variants and five affective temperaments measured by the TEMPS-A. RESULTS: No significant difference in the frequency of alleles between affective temperaments (depressive, cyclothymic, hyperthymic, irritable and anxious temperament) and non affective temperaments was shown. One-way analysis of variance (ANOVA) revealed no significant differences among 5 groups (depressive, cyclothymic, hyperthymic, irritable and anxious temperament) in healthy subjects for all the scores of affective temperaments by TEMPS-A. LIMITATIONS: The number of subjects was relatively small. CONCLUSIONS: The variant of BDNF, GSK3ß and Wnt gene polymorphism might not be related to the five temperaments of TEMPS-A and TEMPS-A score in healthy Japanese subjects. The present results suggest that BDNF, GSK3ßand Wnt genes, might not have a major role in the development of personality traits. Further studies with larger sample size are warranted to evaluate the association of affective temperament and gene polymorphisms.

Even very low but sustained lithium intake can prevent suicide in the general population?

Although several meta-analyses have shown anti-suicidal properties of lithium in treating patients with mood disorders, these effects may be unrelated to the mood-stabilizing effects. Some epidemiological studies suggest that even very low lithium levels induced by routine consumption of lithium from tap water may have anti-suicidal effects both in patients with mood disorders and in the general population. We hypothesize that even very low but sustained lithium intake can prevent suicide in the general population. If this is the case, increasing lithium levels of drinking water could potentially reduce the risk of suicide, and justify administering lithium to tap water.