Dissertations / Theses on the topic 'Bipolar II disorder'

Bakgrund: Vid bipolär sjukdom kan sinnestillståndet skifta mellan upprymt stämningsläge och svår depression. Sjukdomsbilden står i fokus och är grundläggande för att diagnostisera en individ med bipolär sjukdom. Behandling för bipolär sjukdom är framför allt farmakologisk men psykoterapi tillämpas vid behov. Ett gemensamt arbete mellan patient, familjemedlemmar och vårdteamet kan bidra till bättre förutsättningar till återhämtning. Syfte: Syftet var att belysa vuxna personers upplevelser av att leva med bipolär sjukdom. Metod: En allmän litteraturöversikt genomfördes baserad på tio kvalitativa artiklar i resultatet.  Resultat: Vid analys av de sammanställda vetenskapliga artiklarnas resultat framkom det fem teman: att förlora och återta kontrollen, påverkan på interpersonella relationer, påverkan på självbilden/identiteten, upplevelse av stigmatisering och upplevelse av medicinsk behandling. Personer hade svårigheter att kontrollera sina beteenden och humörsvängningarna vid bipolär sjukdom. Kontrollförlusten medförde att de gjorde handlingar som de inte skulle göra när de var symtomfri, vilket skapade känslor av skam och skuld. Sjukdomen påverkade även interpersonella relationer och ledde till förlust av studier, jobb samt identitet. Den maniska episoden kännetecknades av positiva upplevelser, kontrollförlust och pågående pinsamheter. Den depressiva episoden präglades av negativa tankar och känslor. Livsstilsförändringar och olika metoder användes i kombination med medicinering för att hantera sjukdomen. Slutsats: Bipolär sjukdom är en komplex psykisk sjukdom som skapar stort lidande för den drabbade. Symtomen är som berg- och dalbana och oförutsägbar vilket skapar svårigheter att förstå och hantera humörsvängningar. Trots utmaningarna kan sjukdomens omfattning och leva med samt ha ett relativt bra liv med hjälp av olika hanteringsstrategier.
Background: Bipolar disorder is a state of mind the can shift between elevation and severe depression. The disease picture is in focus and is fundamental to diagnosing an individual with bipolar disorder.Treatment for bipolar disorder is primarily pharmacological, but psychotherapy is applied if necessary. Good cooperation between the patient, family members and the care team can help the patient to get better condition for recovery through treatment.  Aim: The aim was to highlight adults' experiences of living with bipolar disorder.  Method: A general literature review was carried out based on ten qualitative articles in the results. Results: An analysis of the results of the compiled scientific articles revealed five themes: losing and regaining control, impact on interpersonal relationships, impact on self-image / identity, experience of stigma and experience of medical treatment. People had difficulty controlling their behaviors and mood swings in bipolar disorder. The loss of control meant that they did actions that they would not do when they were symptom-free, which created feelings of shame and guilt. The disease also affected interpersonal relationships and led to loss of studies, jobs and identity. The manic episode was characterized by positive experiences, loss of control and ongoing embarrassment. The depressive episode was characterized by negative thoughts and feelings. Lifestyle changes and various methods were used in combination with medication to manage the disease. Conclusion: Bipolar disorder is a complex mental illness that creates great suffering for people who have the diagnosis. The symptoms are like a roller coaster and unpredictable, which creates difficulties to understand and manage the mood swings. Despite the challenges, it is possible to limit the extent of the disease and live with it and have a relatively good life with the help of different management strategies.

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There are several studies on the differential diagnosis of Bipolar Disorder (BD), however, further investigation with an emphasis on clinical phenotypes that inaugurate the disease is needed. The aims of this study are to identify the psychiatric disorders most frequently diagnosed before the definitive diagnosis of BD, the time until the correct diagnosis and compare BD I and II for the variables studied. We studied 259 patients with current diagnosis of BD according to the DSM- IV-TR, evaluated by the same psychiatrist. Early psychiatric signs and symptoms were identified through an interview with the patient and family members and were considered suggestive of an initial diagnosis that was coded according to the same diagnostic criteria. The authors analyzed data on patients' age at prodromes suggestive of initial psychiatric diagnosis and time delay to the actual diagnosis of BD. Comparisons were made between sex, schooling and type of BD. The mean age of patients was 41.6 years, with a predominance of adults (19-60 years), women (67.6%), as well as type II BD (68.3%). Patients were on average 24.6 years of age at initial diagnosis, 41.6 years in the diagnosis of BD and the mean time delay between these was 16.9 years. The most common initial diagnoses were depressive disorders (41.3%), anxiety (12.7%), ADHD (8.1%), disorders related to substance abuse (7.7%), somatoform disorders (6 9%), and psychosis (5.4%). BD can be considered a “great imitator” in modern psychiatry, since initial phenotypes can mimic other disorders. BD diagnosis is very delayed in Brazil.
Há diversos estudos sobre o diagnóstico diferencial do Transtorno Bipolar (TB), entretanto, investigações com ênfase nos fenótipos clínicos que inauguram a doença são escassos. Os objetivos deste estudo consistem em identificar as doenças psiquiátricas mais frequentemente diagnosticadas antes do diagnóstico definitivo de TB, assim como o intervalo de tempo até o mesmo; e comparar o pacientes com TB I e II quanto aos diagnósticos iniciais, escolaridade, sexo e faixa etária. Para tanto, estudamos 259 pacientes com diagnóstico atual de TB segundo os critérios do DSM-IV-TR, realizado por um mesmo psiquiatra. Através de entrevistas com o paciente e familiares, identificou-se retrospectivamente os sinais e sintomas precoces considerados sugestivos do primeiro diagnóstico psiquiátrico, segundo os mesmos critérios. Dados relativos à idade dos pacientes no diagnóstico inicial e tempo até o diagnóstico atual de TB foram analisados e comparações foram feitas entre sexo, escolaridade, faixa etária e tipo de TB. A média de idade encontrada foi de 41,6 anos, com predominância de adultos (19-60 anos), do gênero feminino (67,6%), com TB II(68,3%). Os pacientes tinham em média 24,6 anos de idade no diagnóstico inicial, 41,6 anos no diagnóstico de TB e o tempo médio de atraso diagnóstico foi de 16,9 anos. Os diagnósticos iniciais mais frequentemente encontrados foram: transtornos depressivos (41,3%), ansiosos (12,7%), TDAH (8,1%), transtornos relacionados ao abuso de substâncias psicoativas (7,7%), transtornos somatoformes (6,9%) e psicóticos (5,4%). O T pode ser considerado um “grande imitador” moderno da Psiquiatria, posto que fenótipos iniciais podem mimetizar outros transtornos. Há um atraso significativo no diagnóstico do TBno Brasil.

Diss.
Tiivistelmäosa. - University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Department of Psychiatry, Department of Mental Health and Alcohol Research, National Public Health Institute. Myös paperimuodossa (ISBN 978-951-740-693-2).

碩士
國立成功大學
行為醫學研究所
96
Background: Bipolar disorder (BD) is the most common psychiatric condition associated with suicide. However, related literature remains limited and findings are controversial. Despite past research standings, current theories regarding the prognosis are not as optimistic for the soft form of BD due to its intensely chronic depressive features. However, by far, the distinctions of bipolar subgroups, especially for bipolar II, have not been well studied in Asian populations, and the crucial factors related to clinical outcome are unclear. Method: Ninety-three patients (bipolar I: 48; bipolar II: 45) were prospectively followed over a 24 weeks period and evaluated in this study. We investigated the symptomatic severity, suicidal risk (the Adult Suicidal Ideation Questionnaire; ASIQ), insight of illness (the Mood Disorders Insight Scale, MDIS) and quality of life (the Short Form of World Health Organization Questionnaire on Quality of Life-Taiwan Version; WHOQOL-BREF TW) across the mood state of each recruited subject. The socio-demographic information, prescribed medications and the drug compliance were also recorded. Results: The results showed that bipolar II (BPII) patients have a longer duration of onset to treatment, more prominently mixed depression and residual depressive symptoms, higher ASIQ scores in the acute stage, poor psychological QoL and lower prescription during the follow up period than bipolar I patients (BPI). Through the multiple Linear Regression models, three specific illness variables (depression symptoms, ASIQ scores, and the type of BD) could strongly account for mental life satisfaction; the explainable variances were 43.6%. Conclusion: Overall, our results indicated that BPII disorder might be a more severe, chronic subtype, and with special malignancy in comparison with BPI. It is hoped that the present article will bring attention to the markedly impaired psychological QoL in BPII patients and that the specific illness variables relevant to BPI and BPII affecting the clinical outcome can be more clearly delineated in the future.

碩士
國立成功大學
行為醫學研究所
97
Background The literature reports persistent cognitive impairments in patients with bipolar disorder even after prolonged remission. However, a majority of studies have focused only on bipolar I disorder (BP-I), primarily because bipolar II disorder (BP-II) is often underdiagnosed or misdiagnosed. More attention should be paid to the differences between BP-I and BP-II, especially the aspects of neuropsychological functioning. We examined the different neuropsychological functions in BP-I and BP-II patients and compared them with those of healthy controls. Methods The study included 67 patients with inter-episode bipolar disorder (BP-I: n = 30, BP-II: n = 37), and 22 healthy controls compared using a battery of neuropsychological tests that assessed memory, psychomotor speed and certain aspects of frontal executive function. Results The BP-I group performed poorly on verbal memory, psychomotor speed, and executive function compared to the BP-II and control groups. Both bipolar groups performed significantly less well than the control group on measures of working memory and psychomotor speed, while the BP-II group showed an intermediate level of performance in psychomotor speed compared to the BP-I and control groups. There was no difference between the groups on visual memory. Conclusions BP-I was characterized by reduced performance in verbal memory, working memory, psychomotor speed, and executive function, while BP-II showed a reduction only in working memory and psychomotor speed. Cognitive impairment existed in both subtypes of bipolar disorder, and was greater in BP-I patients. Rehabilitation interventions should take into account potential cognitive differences between these bipolar subtypes.

碩士
國立成功大學
行為醫學研究所
100
Aim: The aim of this study was to clarify aldehyde dehydrogenase 2 (ALDH2) and dopamine D2 receptor (DRD2) genes for predisposition to Bipolar II disorder (BP-II) comorbid with and without anxiety disorders (AD). To specify phenotype of BP-II and to reduce heterogeneity in the etiology of BP-II might support that comorbid AD is a subtype of BP-II. Background: The presence of comorbidity compounds disability, complicates treatment, and appears to worse the prognosis of bipolar disorders (BP). The frequently comorbid conditions include substance use disorders and anxiety disorders (AD) (generalized anxiety disorder, social phobia, panic disorder, obsessive compulsive disorder, and post-traumatic stress disorder), but comorbid AD has been underrecognized and understudies. The dopaminergic system has been implicated in the pathogenesis of BP and AD. The genes involved in metabolizing dopamine and encoding dopamine receptors, such as the aldehyde dehydrogenase 2 (ALDH2) and dopamine D2 receptor (DRD2) genes may be important. In the past few decades, a number of studies have investigated the association of DRD2 gene with BP as well as AD, but the findings are controversial. However, the comorbidity rate of AD and BP was relatively lower in the Han Chinese population than in the Western population. It may be easier for us to clarify the association of the DRD2 and ALDH2 polymorphisms and the possible interactions in BP-II with and without AD. Method: The sample consisted of total 462 BP-II patients with Research Diagnostic Criteria for 2-day hypomania cutoff based on DSM-IV-TR. 335 subjects were BP-II without AD, 127 subjects were of BP-II with AD and 348 were healthy subjects as normal control. The diagnosis for each patient was made by an attending psychiatrist and confirmed by a clinical psychologist using the Chinese Version of the Modified Schedule of Affective Disorder and Schizophrenia-Lifetime (SADS-L) to screen their psychiatric conditions. The genotypes of the ALDH2 and DRD2 TaqIA polymorphisms were determined using polymerase chain reactions plus restriction fragment length polymorphism analysis. Results: Logistic regression analysis showed a statistically significant association between DRD2 Taq-I A1/A2 genotype and BP-II with AD (OR=2.231, P=0.021). Moreover, a significant interaction of the DRD2 Taq-I A1/A1 and the ALDH2*1*1 genotypes in BP-II without AD was revealed. (OR=5.623, P= 0.001) to compare with normal control. Conclusion: Our findings support the hypothesis that a unique genetic distinction between BP-II with and without AD, and suggest a novel association between DRD2 Taq-I A1/A2 genotype and BP-II with AD. Our study also provides further evidence that the ALDH2 and DRD2 genes interact in BP-II, particularly BP-II without AD.

碩士
國立成功大學
行為醫學研究所
96
Background: Previous studies found that psychosocial and occupational dysfunctions during the remission period among patients with Bipolar Disorder (BP) were associated with neuropsychological impairments, especially pertaining to executive function and verbal memory disabilities. Clinically, Bipolar I Disorder (BP-I) and Bipolar II Disorder (BP-II) were the most severe and frequently observed subtypes. Due to their distinct pathological characteristics, rehabilitation and intervention programs should be designed accordingly on the basis of the subtypes’ neuropsychological weaknesses to achieve a better treatment outcome. Currently however, reference literatures were limited. Thus, the present study aimed to further examine the different neuropsychological functions in patients with BP-I and BP-II. Method: All subjects were recruited from National Cheng Kung University Hospital. The Schedule for Affective and Schizophrenia-Lifetime Chinese version (SADS-L) were assessed to confirm diagnoses. When the patients’ mood symptoms were stabilized neuropsychological tests were administered. Results: Sixty-three patients diagnosed with BP participated in this study. The results showed that BP-I patients performed significantly worse on the number of categories completed in the Wisconsin Card Sorting test and the recognition total score of Logical Memory II compared to patients with BP-II. Conclusion: Overall, our results indicated that BP-I patients had relatively poorer performances on verbal memory encoding and a greater tendency to forget faster than BP-II patients; in regards to abstractive reasoning, either strategy formulation or planning abilities were comparatively worse in BP-I patients. Thus, clinical practitioners should keep in mind the distinctive characteristics of the two BP subtypes when constructing treatment or rehabilitation programs.

碩士
國立成功大學
臨床藥學與藥物科技研究所
105
Background: Valproate (VPA) is a mood stabilizer for treating patients with bipolar disorder (BD), and it is known to be one of risk factors associated with metabolic disturbances in BD patients. Recent studies had pointed out the metabolic regulation and mood symptoms might be mediated by the common underlying mechanisms. However, previous studies have found that hepatokine FGF21 exerts beneficial effects on lipid and glucose regulation. Nevertheless, current studies indicated that VPA upregulated fibroblast growth factor-21 (FGF21) expression, although the role of FGF21 between mood regulation and valproate treatment outcome in bipolar patients is still unknown. Therefore, we hypothesized that FGF21 is a common mediator in metabolic system and mood disorder. In addition, the role of leptin-leptin receptor system in mood symptom and metabolic regulation is well studied, and our previous studies found that bipolar patient received valproate would increase the peripheral leptin level. Besides, the leptin receptor gene (LEPR) has been associated with metabolic disturbances, yet the association between LEPR polymorphism and valproate-induced metabolic disturbance is still unknown. Materials and Methods: we enrolled patients (aged 18–65 years) who met the Diagnostic and Statistical Manual of Mental Disorders, 4th version (DSM-IV) and the Chinese Version of the Modified Schedule of Affective Disorder and Schizophrenia-Life Time (SADS-L) diagnostic criteria for BD II consecutively. We recruited healthy controls without mental illness from the community. All subjects signed the informed consent and the BD II patients started to receive VPA 500-100mg for 12 weeks. Concomitant fluoxetine for depressive symptoms or lorazepam for nighttime sedation and insomnia were permitted during the study. All BD patients were in major depressive status at the time of study entry, with a 17-item Hamilton Depression Rating Scale (HAMD) score 〉15. The disease severity and metabolic indexes including plasma FGF21 level were measured. The same measurements conducted at 2 weeks, 8 weeks and 12 weeks in BD II patients after the initiation of valproate treatment. The LEPR rs113101, rs1137100, rs1327121, rs8179183, rs12145690, rs4655555, rs6588147, rs10889557, rs9436747 polymorphisms were detected by TaqMan SNP Genotyping Assays. Results: We recruited 137 BD II patients and 78 community-dwelling controls. The mean age of BD II patients and healthy controls were 32.1±11.6 and 31.0±10.7 years old, respectively. There were 51.1% female in BD II patients and 56.4% female in healthy controls. At baseline, the HAMD and YMRS score were higher in BD II patients whereas FGF21 level and metabolic indices did not differ significantly between the controls and BD II patients. After 12 weeks of VPA treatment, the disease severity significantly improved in BD II patients. The FGF21 level (167.7±122 and 207.1±162.3 pg/ml, p=0.001), body weight and waist circumference had increased significantly (p〈0.001 and p=0.028, respectively). Result 1: The baseline FGF21 was significcantly positively correlated with waist circumference and TG level in both populations after adjustment for age (in healthy controls: r=0.310 and p=0.009, r= 0.461 and p〈0.001, respectively; in BD II patients: r=0.231 and p=0.008, r=0.187 and p=0.033, respectively). However, there was no correlation between FGF21 and disease severity in both groups at baseline. Moreover, the change in FGF21 level was significantly correlated with the changes in HAMD score (r=0.393, p=0.002), total cholesterol (r=−0.344, p=0.008), HDL (r=−0.298, p=0.022) and LDL (r=−0.347, p=0.007). Furthermore, the change in FGF21 level was specifically correlated with change score in insomnia and anxiety subscale from HAMD scores (p=0.004, p=0.042, respectively). Result 2: Regarding the analysis of the LEPR polymorphism in our population, we found that LEPR SNPs rs1137100, rs1137101, rs1327121, rs6588147, rs10889557, rs4655555 were associated with body weight and waist circumference in healthy controls. In BD patients at baseline, we found that rs10889557 and rs12145690 were associated with total cholesterol level. Moreover, rs1137100 AA or AG carriers had a higher YMRS score than GG carriers (10.4±4.1 vs. 8.8±3.9, p=0.032). After 12-week treatment course, rs1137100 AA or AG carriers had a higher portion of YMRS remitter than GG carriers (43.5% vs.25.0%, p=0.030). On the other hand, regarding the interaction effect of LEPR polymorphism and VPA treatment on the treatment response and metabolic indices, the results showed that rs1137100 and rs12145690 influenced the hip circumference and total cholesterol level during the treatment course. In addition, rs9436747, rs6588147, rs8179183 influenced the insulin level and the value of HOMA-IR during the treatment course. However, the above results of LEPR polymorphism were not statistically significant after Bonferroni correction. But the effect of rs1137100 on the change level of total cholesterol during the treatment course, and the effect of rs8179183 on the value of triglyceride, insulin, and HOMA-IR during the treatment course remained statistically significant after Bonferroni correction. We further analysis the LEPR haplotype frequencies in our population. The commonest LEPR haplotype in BD II patients and healthy controls was haplotype 1 (CGGA: rs12145690 /rs1137100 /rs1137101 /rs4655555), and the frequency was 63.3% and 62.7%, respectively. The haplotype frequencies were not different between the two populations. Regarding the treatment response in BD II patients, the frequency of LEPR haplotype CAGA was significantly different between YMRS responders and non-responders (9.2% and 2.2%, p=0.011). Conclusion: Our findings suggested that FGF21 could be a common mediator of a shared mechanism of mood response and metabolic effects in VPA-treated BD patients. FGF21-based therapies could potentially represent novel targets to prevent and treat a variety of mood and metabolic disorders. On the other hand, the LEPR polymorphism was associated with mood and metabolic regulation in BD II patients during the VPA course. Moreover, LEPR haplotype 6 conferred susceptibility to mania treatment response in our patients. In the future study, we may use complicated models, such as functional linear model or artificial neural networks to predict VPA treatment outcome.

Orientação : Jorge Oliveira
O presente estudo teve como objetivo investigar a tomada de decisão numa amostra clínica de indivíduos com diagnóstico de perturbação bipolar (PB). A amostra foi composta por 11 indivíduos com diagnóstico de PB tipo I e 14 indivíduos com diagnóstico de PB tipo II, em fase de eutimia, através da aplicação de uma bateria de provas de avaliação neuropsicológica. Pretendeu-se ainda efetuar uma comparação entre a amostra recolhida e os dados normativos, bem como efetuar uma comparação entre estes dois grupos e verificar a existência de variações em função do diagnóstico de PB ao nível das funções cognitivas, atenção, memória e funções executivas, controlo inibitório e tomada de decisão. Pretendeu-se, por fim, efetuar uma análise exploratória de alguns dos dados clínicos e demográficos recolhidos. Os resultados obtidos revelaram existência de défices significativos ao nível das funções cognitivas e executivas em pacientes com PB quando comparados com a população geral, sugerindo défices ao nível da tomada de decisão em pacientes com PB. Não foram evidenciadas diferenças significativas entre o grupo de PBI e o grupo de PBII. Foi encontrada uma correlação entre défices cognitivos e um baixo nível de escolaridade, tendo-se concluído que existem algumas discrepâncias nos resultados encontrados na literatura ao nível das funções cognitivas e executivas, bem como a falta de estudos ao nível da tomada de decisão em pacientes eutímicos com PB. Défices nas funções cognitivas e executivas, na PB parecem ser uma característica estável da doença, evidenciando défices nas estruturas frontais, remetendo para uma maior disfunção ao nível dos neurónios do córtex pré-frontal, sugerindo a existência de défices ao nível da tomada de decisão. No entanto, mais estudos são necessários para validar este resultado. Os défices cognitivos observados em pacientes com PBI e PBII eutímicos são difíceis de diferenciar. Um desempenho cognitivo inferior em pessoas com PB está associado a baixos níveis de escolaridade. Considera-se portanto que a avaliação neuropsicológica é fundamental na compreensão dos défices cognitivos existentes em pessoas com PB.
This study aimed to investigate decision making processes in a clinical sample individuals diagnosed with Bipolar Disorder (BD). The sample comprised 11 individuals diagnosed with BD type I and 14 individuals diagnosed with bipolar disorder BD type II in euthymia stage, by applying a battery of neuropsychological tests. The study also aimed to compare the scores from this sample with normative data, and between these two groups to study whether diagnosis affects cognitive function, attention, memory and executive functions, inhibitory control and decision. Also, this study aimed to do an exploratory analysis of some of the clinical and demographic data. The results showed the existence of significant deficits in cognitive and executive functions in patients with BD compared with the general population, suggesting deficits in the decision-making levels in patients with BD. No significant differences were found between the BDI group and BDII group. A correlation between cognitive deficits and a low level of education was found, which suggest that there are some discrepancies in the results reported in the literature in terms of cognitive and executive functions as well as the lack of studies to decision-making levels in euthymic patients with BD. The deficits in cognitive and executive functions in BD seem to be a stable characteristic of the disease, showing deficits in frontal structures, referring to greater dysfunction at the level of the prefrontal cortex neurons, suggesting the possibility of deficits at the connection decision. Nevertheless, further studies are needed to validate this conclusion. The cognitive deficits observed in patients with BDI and euthymic BDII are difficult to differentiate. A lower cognitive performance in people with PB is associated with low levels of education. These findings highlight the importance of neuropsychological assessment in understanding cognitive deficits in people with BD.

碩士
國立成功大學
行為醫學研究所
96
Background: Sustained attention deficit was the most commonly reported impairments in bipolar disorder. The goal of this study was to compare the sustained attention of inter-episode patients with BP I to those with BP II disorder. Methods: 51 patients with bipolar disorder (22 BP I and 29 BP II) and 20 healthy controls participated in this study and were tested with Conners' Continuous Performance Test-II (CPT). Psychiatric symptoms were assessed with the 17-item Hamilton depression rating scale and Young Mania Rating Scale. Results: A significant and negative relation was shown merely between years of education and omission errors in patients with BP I and BP II (r=-0.320, p＜0.01). Patients with BP I had a significantly longer response latency (F(2,68)=7.648, p=0.001) (reaction time, RT), RT standard error (F(2,68)=5.252, p=0.008), worse d’ (F(2,68)=6.313, p=0.003) and more commission errors (F(2,68)=6.182, p=0.004) than those with BP II and healthy controls. No significant difference was found among these three groups on omission errors and no significant correlations were observed between CPT performance and clinical characteristics in these three groups. Limitations: A longitudinal follow-up study design and larger sample size might provide more information on whether sustained attention deficit in BP patients is a premorbid issue or not and might have illustrated clearer differences between the three groups. Conclusions: These findings suggested that impairments in sustained attention might be more representative of BP I than BP II, even after controlling for the severity of symptoms, age, years of education and reaction time.

碩士
國立成功大學
行為醫學研究所
98
Background: It has been debated whether bipolar II disorder (BP-II) a distinct disorder or simply a milder form of bipolar I disorder (BP-I). Methods: In this cross-sectional survey (2005-2009), we administered the Hamilton Depression Rating Scale (HDRS), the Young Mania Rating Scale (YMRS), and the Tridimensional Personality Questionnaire (TPQ) to 314 participants (82 BP-I patients, 121 BP-II patients, and 111 healthy controls). The Ser9Gly polymorphism of the dopamine D3 receptor gene (DRD3), and the serotonin transporter gene-linked polymorphic region (5-HTTLPR) genotypes were examined. All the patients met the DSM-IV-TR diagnosis of bipolar disorder. Results: Multinomial logistic regression analysis showed a significant main effects for the 5-HTTLPR polymorphism (p = 0.045), novelty seeking (NS) (p = 0.033) and harm avoidance (HA) (p = 0.012) scores, and a significant interaction effect between HA and 5-HTTLPR genotypes (p = 0.047) in distinguishing between BP-I and BP-II patients. BP-I patients with the long allele at 5-HTTLPR had lower HA scores than did BP-II patients (BP-I = 16.23, BP-II = 19.80; p = 0.023). Multinomial analysis also showed that NS (p = 0.001) and HA (p = 0.001) scores significantly differed between BP-I patients and healthy controls (HC). However, only HA (p ＜ 0.001) significantly differed between BP-II patients and healthy controls. All these data suggest a distinction between BP-I and BP-II. Conclusions: We provide initial evidence that 5-HTTLPR genotypes moderated the association between HA and BP-I and BP-II. We hypothesize that there are unique differences in the gene-temperament interactions of BP-I and BP-II patients.