This study psychopathologically analyzes and compares the premorbid personalities associated with bipolar II disorder and unipolar depression. Using Cloninger’s tridimensional personality theory, we evaluated 14 inpatients with bipolar II disorder and 14 inpatients with unipolar depression. The results indicate that the premorbid personality associated with bipolar II disorder is characterized as ‘the reward-dependent, passive-avoidant/dependent tendency of personality’ or ‘the dependent tendency of personality’. We also clarified that atypical symptoms of bipolar II disorder, such as the hypomanic state and the mixed state, were induced by the mingling of this tendency with the melancholic personality type (Tellenbach) or the cycloid personality type (Kretschmer), both of which are based on syntony (Minkowski), categorized by the use of an obsessional defense mechanism to maintain stable social relations. When an insufficiency in the obsessional defense weakens the syntony, the dependent tendency engenders the symptoms stated above. Although few serious problems associated with the dependent tendency may have occurred previously, it may have resulted in conflicts with others after onset of the bipolar II disorder. Therefore, psychotherapy for these conflicts is necessary along with the administration of mood stabilizers.

Keywords:
Bipolar II disorder, Premorbid personality, Tridimensional personality concept
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© 2000 S. Karger AG, Basel
2000
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