The relationship of premorbid personality to subtypes of an affective illness. A replication study by means of an operationalized procedure for the diagnosis of personality structures.

The hypothesis of a relationship between types of premorbid personality and subtypes of an affective illness was tested on the basis of a diagnostically 'blind' assignment of biographical case history data on patients' premorbid development to patterns of personality traits. Data sets of 261 cases with various psychiatric disorders were examined. The rater (R.T.) had to score each item in a list of traits relevant for the diagnosis of the types that had been conceived by D.v.Z. and J.P. The assignment of the ratings to the type concepts was then performed by means of a computer programme. The results regarding the distribution of types over the clinical diagnoses yielded a statistically significant association of the 'affective types' of premorbid personality ('melancholic type' and 'manic type') with affective disorders and the 'neurotoid types' ('anxious insecure type' and 'nervous tense type') with non-affective disorders. Previous findings on the basis of a global rating of types in a smaller sample (n = 42) regarding personality types and subtypes of an affective illness could be replicated by means of the new, operationalized procedure in an enlarged sample (n = 80): On the one hand, a marked preponderance of the 'manic type' of personality was found in bipolar I patients, particularly pronounced in those with a predominantly manic course of the disorder; on the other hand, the 'melancholic type' of personality prevailed in bipolar II and unipolar depressive patients.