Homocysteine, hopelessness, rumination, affective temperaments, and clinical course in patients with bipolar disorder-1

Abstract

Purpose

This study aimed to explore the associations between homocysteine, rumination, affective temperaments, clinical features, and hopelessness in bipolar disorder-1 (BD-1).

Materials and methods

In total, 57 euthymic patients with BD-1 and 57 healthy controls were included. The Beck Hopelessness Scale (BHS), Temperament Evaluation of Memphis, Pisa, Paris, and San Diego-Autoquestionnaire (TEMPS-A), and Ruminative Responses Scale Short Form (RRS-SF) were administered. Homocysteine, folate, and vitamin B12 levels were measured.

Results

The BHS total (p = 0.047), TEMPS-A irritable (p = 0.007), and TEMPS-A cyclothymic (p= 0.001) scores were significantly higher than the control group in the BD-1 group. Hyperhomocysteinemia (HHcy) was found in 33.3% of the patients (n = 19). In the HHcy group, age of onset of disease (p = 0.020) was significantly lower than the non-HHcy group in patients. Previous suicide attempt number was significantly correlated with scores of reflective pondering, brooding, and global rumination in BD-1 (p ˂ 0.05). Except for hyperthymic temperament, all types of affective temperaments were correlated with the scores of RRS-SF brooding (p ˂ 0.05) in the BD-1 group. The RRS-SF brooding scores significantly correlated with the BHS total scores (r = 0.263, p < 0.05); the TEMPS-A hyperthymic (β = −0.351, p = 0.001) and TEMPS-A irritable (β = 0.536, p < 0.001) scores significantly predicted the BHS total scores in the BD-1 group.

Conclusions

The findings may lead clinical efforts and future clinical trials to explore and intervene in related sources and presentations of BD-1’s adverse consequences.

Keywords:

• Bipolar disorder
• temperament
• hope
• homocysteine
• rumination, cognitive

Authors’ contributions

E.F.A., H.Ö., and S.A.: conceptualization. E.F.A., H.Ö., S.Y., S.A., T.K.L., and E.N.T.: methodology. S.Y. and E.F.A.: data analysis. T.K.L. and E.N.T.: data curation. E.F.A., S.Y., S.A., and H.Ö.: manuscript writing. All authors read and approved the submitted version of the manuscript.

Conflict of interest statement

The authors declare no conflicts of interest.

Data availability statement

The data material of this study is available upon request from the corresponding author.

Additional information

Funding

This study was supported by Atatürk University Scientific Research Project Office funded this study. Project ID: 9598 and project code: TAB-2021–9598.

Notes on contributors

Esat Fahri Aydın

Esat Fahri Aydn is a psychiatrist, a diplomate of the Academy of Cognitive Therapy, and an assistant professor in the psychiatry department at Atatürk University Faculty of Medicine. His research focuses on personality, thinking styles, and their associations with psychopathology.

Halil Özcan

Halil Özcan is a psychiatrist and professor in the psychiatry department at Atatürk University Faculty of Medicine. His research interests are psychopharmacology, neuromodulation, and bipolar disorder.

Sinan Yılmaz

Sinan Ylmaz is a medical doctor and associate professor in the public health department at Atatürk University Faculty of Medicine.

Seda Aşkın

Seda Akn is an assistant professor in the Health Services Vocational School at Atatürk University. She is a biologist with a PhD in biochemistry.

Tuğba Koca Laçin

Tuba Koca Laçin is a psychiatrist in the psychiatry department at Ankara Etlik City Hospital. Her research interests include bipolar disorder, sleep and genetics.

Elif Nur Topu

Elif Nur Topu is a resident in the psychiatry department at Atatürk University. She is interested in bipolar disorder.