Towards an evolutionary perspective of bipolar disorders: Is there a genetic link between bipolar disorders and non-pathological (adaptive) hyperactivity?

The new-developed Questionnaire for Adaptive Hyperactivity and Goal Achievement (AHGA), represents an innovative approach to hyperthymic features by embracing a broader concept of spectrum, which conceptualizes as a continuum the potential transition between pathological and adaptive aspects. The two basic components of the hyperthymic temperament that stand out are hyperactivity and goal achievement. This kind of temperament can be classified as abnormal only in the presence of chronic hypomanic symptoms or advanced mood disorders. In general, temperaments have been verified to belong to the domain of normality rather than the sphere of pathology, in accordance with their putative adaptive role. Commonly, achieving success, experiencing excitement and joy, and moving towards core life goals are moments of great importance in life. In this approach, goal and drive achievement demonstrates an adaptive and beneficial side of hyperthymia. It indicates the willingness to set high goals and spend energy pursuing them, which could help clarify the high rates of creative efforts among people with a hyperthymic temperament. However, the pathological scenery appears linked to variability in the adaptiveness with which people follow life goals and accomplishments. In the later stages of the study, this tool was very helpful in identifying older adults (60 years of age and older) with features of well-defined hyperactivity and novelty-seeking. The Questionnaire for Adaptive Hyperactivity and Goal Achievement (AHGA) measures the adaptive characteristics of hyperactivity and goal pursuit in contrast to the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) tool, which measures its pathological characteristics. According to the results regarding the investigated genetic variant (RS1006737) of the CACNA1C gene, an association was found with the characteristics of hyperactivity rather than just BD. Also, this genetic variant, recognized in the literature as associated with bipolar disorders, was found in well-adapted older adults without bipolar disorders and high hyperactivity traits with a similar frequency as in older adults with a diagnosis of bipolar disorders but higher than in older adults without bipolar disorders and without hyperactivity. This could led to the new interpretation and a new approach to supporting drug therapy in which the rediscovery of the adaptive potential resources would be central to the recovery of the individual who has suffered a bipolar disorder onset. Furthermore, the interpretation of the disorder not as the simple consequence of a genetic weakness could be an element against stigma and self-stigma. When comparing the biological material, although saliva and blood differ in composition and biological properties, sample type has no effect on the detection of a mutation in the genetic variant of interest. Blood and saliva can both be used as biological materials in later stages of this research. The combination of the new questionnaire tool (Questionnaire for Adaptive Hyperactivity and Goal Achievement) with the genetic analysis appears to be an innovative, practicable, and original approach. The following development of this study will include more genetic variables with higher susceptibility for bipolar disorders (ANK3, NCAN, ODZ4, SYNE1, and TRANK1 genes) and obviously more numerous target and control samples.