By Mark Cowen, Senior MedWire Reporter
Results from a Danish study suggest that seven early maladaptive schemas (EMSs) play a significant role in functional impairment among patients with bipolar disorder (BD).
Kristine Nilsson (Aarhus University) found that, after controlling for length of remission and subsyndromal depressive symptoms, seven specific EMSs accounted for 28% of the variance in functional impairment in a study of 49 remitted patients with BD.
"The present study concurs with prior research in suggesting that in BD patients, negative ways of perceiving oneself is associated with functional impairment," says Nilsson.
"The findings furthermore elaborate this understanding by identifying particular self-schemas associated with functional impairment in BD patients."
All of the participants (35% male), who were aged a mean of 35.4 years and had been in remission for a mean of 10.1 months, were assessed for 18 EMSs using the Young Schema Questionnaire-Short Version.
They were also assessed for functional impairment using the Work and Social Adjustment Scale (WSAS), with higher scores equating to more severe impairment, and for affective symptoms using the Bech-Rafaelsen Mania Scale and the Bech-Rafaelsen Melancholia Scale.
Nilsson found that there was no significant correlation between the WSAS total score and age, gender, annual frequency of previous affective episodes, polarity of the most recent affective episode, or subsyndromal manic symptoms.
However, increased total WSAS scores were significantly correlated with fewer months of remission and more subsyndromal depressive symptoms.
Total WSAS scores were also highly correlated with the EMSs of social isolation, failure to achieve, dependence, vulnerability to harm and illness, emotional inhibition, insufficient self-control, and pessimism.
These seven schemas together with length of remission and subsyndromal depressive symptoms accounted for 61% of the variance in functional impairment, after accounting for other variables.
Nilsson concludes in the Journal of Behavior Therapy and Experimental Psychiatry: "The findings add to previous research in underlining the relevance of EMSs in BD patients, as well as stress the need for targeting these vulnerabilities through psychotherapeutic interventions."
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