STUDY ASSUMPTIONS Bipolar disorder is a severe psychiatric disorder with significant delays in diagnosis, which significantly impacts the quality of life and the daily functioning of affected individuals. While there has been growing interest in the study of affective temperament, chronotype and emotional dysregulation in bipolar spectrum disorders, emotional dysregulation in the general population remains remarkably understudied. This gap in knowledge may have critical implications for early diagnosis and the duration of untreated illness. AIM OF THE STUDY The aim of the present study was to identify subjects with emotional dysregulation in the general population and to investigate their association with affective temperaments, prevalent chronotype and subthreshold bipolarity. Validation of the results of this study in a non-clinical setting could be translated into an outpatient setting, with the aim of facilitating early diagnosis and differential diagnosis. MATERIALS AND METHODS The present observational study involved 2031 participants of adult age, belonging to the general population. The subjects were recruited in 2022 at COVID-19 points of care, in the city of Padua. The following self-reported questionnaires were administered to the participants: the DERS (Difficulties in Emotion Regulation Scale) to assess emotional dysregulation, MDQ (Mood Disturb Questionnaire) and HCL-32-R2 (Hypomania Check List-32, second revision) to investigate the risk of subthreshold bipolarity, and the TEMPS-M brief (brief Temperament Evaluation of the Memphis, Pisa, Paris and San Diego) to study affective temperaments, finally the rMEQ (reduced Morningness Eveningness Questionnaire), to explore chronotype. RESULTS Individuals with high DERS values reported significantly higher scores than subjects with non-high DERS on all TEMPS subscales, with the exception of hyperthymic temperament. Compared to those with non-high DERS values, individuals with high DERS showed significantly higher values on both subscales exploring subthreshold bipolarity (MDQ and HCL-32) and a significantly higher frequency of individuals who tested positive on both MDQ and HCL-32 screening tests. Furthermore, individuals with higher emotional dysregulation showed a significantly higher frequency of evening chronotype than those with non-high DERS values. In the subpopulation with high DERS there was an association with cigarette consumption and drug use. CONCLUSIONS The results of the study made it possible to observe that the population with higher emotional dysregulation has an increased risk of serotype serotype, depressive, cyclothymic, irritable and anxious affective temperaments, and of developing subthreshold bipolar disorder. The finding of the association between these psychopathological domains makes it possible to enrich the pool of data in the current literature, as previous studies carried out in the general population have focused more on the analysis of these scales in a disjointed manner. Therefore, as there is no solid literature to support this thesis, further prospective longitudinal studies are required to confirm the results obtained and to allow causal inferences to be made.
PRESUPPOSTI DELLO STUDIO Il disturbo bipolare è una patologia psichiatrica severa, la cui diagnosi è spesso associata a un notevole ritardo, con ripercussioni sulla qualità della vita e sul funzionamento delle persone affette. Sebbene negli ultimi anni vi sia stato un crescente interesse verso lo studio dei temperamenti affettivi, del cronotipo e della disregolazione emotiva nei disturbi dello spettro bipolare, quest'ultima risulta poco studiata nella popolazione generale. Tale carenza di conoscenze potrebbe avere implicazioni significative sulla diagnosi precoce e sulla durata di malattia non trattata. SCOPO DELLO STUDIO Il presente studio si è posto l’obbiettivo di individuare nella popolazione generale i soggetti con elevata disregolazione emotiva e di indagarne l’associazione con temperamenti affettivi, cronotipo prevalente e bipolarità sottosoglia. La validazione dei risultati di questo studio in un contesto non clinico potrebbe essere tradotta in un setting ambulatoriale, con lo scopo di facilitare la diagnosi precoce e la diagnostica differenziale. MATERIALI E METODI Il presente studio osservazionale ha coinvolto 2031 partecipanti di età adulta appartenenti alla popolazione generale. I soggetti sono stati reclutati nel 2022 nei points of care COVID-19 di Padova. Ai partecipanti sono stati somministrati i seguenti questionari self-reported: DERS (Difficulties in Emotion Regulation Scale) per valutare la disregolazione emotiva, MDQ (Mood Disturb Questionnaire) e HCL-32-R2 (Hypomania Check List-32, second revision) per indagare il rischio di bipolarità sottosoglia, brief TEMPS-M (brief Temperament Evaluation of the Memphis, Pisa, Paris and San Diego) per studiare i temperamenti affettivi, infine rMEQ (reduced Morningness Eveningness Questionnaire) per esplorare il cronotipo. RISULTATI Gli individui con valori di DERS elevati hanno riportato punteggi significativamente maggiori rispetto ai soggetti con DERS non elevata su tutte le sottoscale TEMPS, ad eccezione del temperamento ipertimico. Rispetto a coloro con valori di DERS non elevati, gli individui con DERS elevata hanno mostrato valori significativamente maggiori di entrambe le scale che esplorano la bipolarità sottosoglia (MDQ e HCL-32) e una frequenza significativamente maggiore di individui che sono risultati positivi ad entrambi i test di screening MDQ e HCL-32. Inoltre, i soggetti con maggiore disregolazione emotiva, hanno mostrato una frequenza significativamente maggiore di cronotipo serotino rispetto a coloro con valori di DERS non elevati. Nella sottopopolazione con DERS elevata è emersa un’associazione con il consumo di sigarette e con l’utilizzo di sostanze stupefacenti. CONCLUSIONI I risultati dello studio hanno permesso di osservare che la popolazione a più elevata disregolazione emotiva presenta un aumentato rischio di cronotipo serotino, di temperamenti affettivi depressivo, ciclotimico, irritabile e ansioso, di presentare caratteristiche di bipolarità sottosoglia. Il riscontro dell’associazione tra questi domini psicopatologici consente di arricchire il pool di dati presenti nella letteratura attuale, in quanto i pregressi studi effettuati nella popolazione generale si sono maggiormente focalizzati sull’analisi di tali scale in maniera disgiunta. Pertanto, non essendoci una letteratura solida a supporto della presente tesi, sono necessari ulteriori studi prospettici longitudinali che confermino i risultati ottenuti e che consentano di formulare delle inferenze causali.
Fattori associati alla disregolazione emotiva in individui sani: uno studio osservazionale.
BORGHERO, LINDA
2023/2024
Abstract
STUDY ASSUMPTIONS Bipolar disorder is a severe psychiatric disorder with significant delays in diagnosis, which significantly impacts the quality of life and the daily functioning of affected individuals. While there has been growing interest in the study of affective temperament, chronotype and emotional dysregulation in bipolar spectrum disorders, emotional dysregulation in the general population remains remarkably understudied. This gap in knowledge may have critical implications for early diagnosis and the duration of untreated illness. AIM OF THE STUDY The aim of the present study was to identify subjects with emotional dysregulation in the general population and to investigate their association with affective temperaments, prevalent chronotype and subthreshold bipolarity. Validation of the results of this study in a non-clinical setting could be translated into an outpatient setting, with the aim of facilitating early diagnosis and differential diagnosis. MATERIALS AND METHODS The present observational study involved 2031 participants of adult age, belonging to the general population. The subjects were recruited in 2022 at COVID-19 points of care, in the city of Padua. The following self-reported questionnaires were administered to the participants: the DERS (Difficulties in Emotion Regulation Scale) to assess emotional dysregulation, MDQ (Mood Disturb Questionnaire) and HCL-32-R2 (Hypomania Check List-32, second revision) to investigate the risk of subthreshold bipolarity, and the TEMPS-M brief (brief Temperament Evaluation of the Memphis, Pisa, Paris and San Diego) to study affective temperaments, finally the rMEQ (reduced Morningness Eveningness Questionnaire), to explore chronotype. RESULTS Individuals with high DERS values reported significantly higher scores than subjects with non-high DERS on all TEMPS subscales, with the exception of hyperthymic temperament. Compared to those with non-high DERS values, individuals with high DERS showed significantly higher values on both subscales exploring subthreshold bipolarity (MDQ and HCL-32) and a significantly higher frequency of individuals who tested positive on both MDQ and HCL-32 screening tests. Furthermore, individuals with higher emotional dysregulation showed a significantly higher frequency of evening chronotype than those with non-high DERS values. In the subpopulation with high DERS there was an association with cigarette consumption and drug use. CONCLUSIONS The results of the study made it possible to observe that the population with higher emotional dysregulation has an increased risk of serotype serotype, depressive, cyclothymic, irritable and anxious affective temperaments, and of developing subthreshold bipolar disorder. The finding of the association between these psychopathological domains makes it possible to enrich the pool of data in the current literature, as previous studies carried out in the general population have focused more on the analysis of these scales in a disjointed manner. Therefore, as there is no solid literature to support this thesis, further prospective longitudinal studies are required to confirm the results obtained and to allow causal inferences to be made.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/72481