Efeito da personalidade na conversão de transtornos depressivos unipolares para bipolares

Abstract

Background: Mood disorders are highly prevalent in the population, and their comorbidity with personality disorders is quite common. Studies point to a worse prognosis in the evolution and response to treatment of the depressive disorder in those individuals with comorbid personality disorders. Objective: The aim of this research was to evaluate the effect of personality traits on the conversion of unipolar to bipolar depressive disorders. Method: An analysis of the impact of the presence of disorders or personality traits on the outcome of conversion to bipolar disorder was carried out through the longitudinal follow-up of a population of individuals from the city of Pelotas, who were initially included in the study with a diagnosis of unipolar depression and were reevaluated again after about 3 years. In addition, a systematic review of the literature present so far was carried out. Results: Two articles were prepared on the aforementioned theme, one of which was a prospective study and the other a systematic review from the main databases currently available.. In general, the findings of our study, explored in the prospective cohort study, show that the presence of Cluster B personality disorders increases the risk of conversion to bipolar disorder. On the other hand, the systematic review identified the existence of few studies on the subject, with no consensus in the literature on whether or not personality disorders are a risk factor for diagnostic conversion. The articles found, by the way, were quite heterogeneous, making it impossible to elaborate a metaanalytical result, as was the initial intention. Conclusion: Finally, our prospective cohort study pointed to a probable association between some personality types with a higher risk of conversion to bipolar disorder, although our systematic review has shown that there is no clear consensus on this. In practice, this finding supports the intuitive idea, which already exists in the clinic, that some personality profiles are related to a greater risk of conversion and that, therefore, point to a greater need for caution in the conduct of treatment. The importance of these results is that they may contribute to the suspicion of a higher risk of conversion and, therefore, to a possible earlier diagnosis of bipolar disorder, which can have a great impact on the prognosis and evolution of this disease. It is important to emphasize that, as our findings are not consensually supported by other studies, there is a need for further investigation regarding this relationship found.