Temperament and morbidity in bipolar disorder: A latent profile analysis of the TEMPS-A scale and its impact on the long-term illness course.

BACKGROUND

Bipolar disorders are amongst the most common, severe and chronic mental health conditions, often associated with unpredictable illness trajectories. Temperament, as a relatively stable however underutilized affective trait in clinical practice, has been proposed as a potential modifier of illness course in BD. The current study sought to classify and examine temperament as a predictive or distinguishing factor in the course of bipolar illness.

METHODS

Ninety-one initially euthymic individuals with BD I or II were followed for a period of two years. Latent profile analysis (LPA) was conducted based on self-reported temperament (TEMPS-A scale) and used to identify temperament-based subgroups. Longitudinal illness burden was measured using an adapted Morbidity Index (MI), and stepwise multiple regression was performed to test whether temperament classes predicted MI scores.

RESULTS

The LPA identified three distinct classes: moderate-reactive, reactive-instable, and resilient-hyperthymic temperament. Individuals in the moderate-reactive (vs. the resilient-hyperthymic) class showed significantly higher MI scores, indicating a worse longitudinal illness course.

CONCLUSION

Temperament classes - reflecting combinations of traits rather than single dimensions alone - may serve as clinically meaningful predictors of illness burden in BD. The potential improvement of incorporating temperament profiles into clinical assessment to identify high-risk patients and guide more tailored treatment approaches is discussed.