Irritable temperament and lifetime psychotic symptoms as predictors of anxiety symptoms in bipolar disorder

Purpose: Affective temperaments, hopelessness, alexithymia, and anxiety/agitation symptoms may play a significant role in the psychopathological characteristics of bipolar disorder (BD). Here, we aimed to investigate the eventual association between the mentioned explanatory variables and anxiety/agitation symptoms in BD. Materials and methods: We recruited at the Section of Psychiatry, Department of Neuroscience, University of Genoa (Italy), 92 BD inpatients having a mean age of 52 (±13.8) years. Participants were assessed using specific psychometric instruments. Anxiety/agitation symptoms have been evaluated using the 11-item of the Beck Depression Inventory II (BDI-II). Results: Overall, 53.8% of participants presented with anxiety/agitation symptoms and 46.2% without. The two groups significantly differed about socio-economic status, lifetime psychotic symptoms, and residual depressive symptoms between episodes. Anxiety/agitation symptoms significantly correlated with irritable affective temperament (r = 0.407; p =.01), hopelessness (r = 0.541; p ≤.001), difficulty identifying feelings (r = 0.440; p ≤.001), difficulty describing feelings (r = 0.437; p ≤.001), and externally oriented-thinking (r = 0.393; p ≤.001). After multivariate analyses, irritable affective temperament (OR = 2.457, p ≤.01) and less lifetime psychotic symptoms (OR = 0.007, p ≤.05) remained the only significant variables associated with anxiety/agitation symptoms. Conclusions: The generalization of the main findings is limited by the small sample size and cross-sectional study design. Nevertheless, our results suggest that the careful assessment of affective temperaments and psychotic symptoms may help to early identify BD patients suffering from anxiety/agitation symptoms and may allow to perform targeted interventions in the clinical practice.