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

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.