Affective temperaments and subthreshold symptoms spectrum in a clinical sample [Temperamenti affettivi e spettri di psicopatologia sottosoglia in un campione di popolazione clinica]

Objective: Evaluation of subthreshold conditions and affective temperaments in a clinical sample; evaluation of relationship between temperament and subthreshold spectrum symptoms and comparison of the two related interviews TEMPS-I and MOODS-SR. Methods: Akiskal's Semi-structured Clinical Interview for Temperament (TEMPS-I) and the General 5-Spectrum Measure (GSM-V) has been distributed to a sample of 92 outpatients. Each patient then received the complete spectrum interview (MOODS-SR, PAS-SR, ABS-SR, OBS-SR, SHY-SR) corresponding to the domain of the GSM-V where more than 2/3rds of the items had been rated positively. Results: In our sample, 47 pazients out of 92 (51.08%) were rated positively for an affective temperament: 33 (35.9% of the whole sample) for depressive temperament, 8 (8.7%) for cyclothymic, 4 (4.3%) for hyperthymic and 2 (2.2%) for irritable. There was no significant relationship between temperament scores and diagnoses. Analysing the presence of subthreshold symptoms in the groups with an extreme affective temperament, 20 patients (45.5%) scored significantly on the mood spectrum, 5 (41.7%) scored significantly on the obsessive-compulsive spectrum, 4 (33.3%) scored significantly on the panic-agoraphobic spectrum and 7 (31.8%) scored significantly on the social-phobic spectrum (Table II). A Chi-Square analysis showed a positive correlation between extreme affective temperaments and mood spectrum scores (p = 0.031; OR = 5.174; CI = 1.051-31.07) (Table III), while no correlation was found between extreme affective temperaments and scores on the spectrum interviews related to anxiety disorders. Thus, the patient group with extreme affective temperaments had a greater chance of scoring positively also at the mood spectrum interview, compared to the group without an extreme affective temperament. However, the percentage of significant mood spectrum scores in the group positive for affective temperaments did not differ in a relevant fashion from the percentage of significant scores of subthreshold symptoms related to anxiety disorders. Conclusions: Conclusions emerging from this study should be viewed as preliminary due to the limited size of our sample. Albeit, a positive correlation was found between extreme affective temperaments and subthreshold mood spectrum features. Taking into account the different background approaches of the two questionnaires TEMPS-I and MOODS-SR, MOODS-SR could perhaps be considered as less specific but more complete as an instrument aimed at detecting clinically relevant different features of affective psychopathology. Our sample also shows how affective temperaments and subthreshold mood spectrum symptoms often coexist with full blown or subthreshold conditions other than affective disorders. This suggests that temperament questionnaires could be used for rapid screening seeking a specific risk of affective pathology, while interviews for subthreshold spectrum symptoms could be useful to examine and describe the specific and individual characteristics of each clinical case in a less subjective and more standardized way.