Determinants of the remission heterogeneity in bipolar disorders: The importance of early maladaptive schemas (EMS)

JOURNAL OF AFFECTIVE DISORDERS

卷:277

Article

Munuera, Caroline¹  Roux, Paul^4,5,6  Weil, Francois^3,4,5  Passerieux, Christine^3,4,5,6  M'Bailara, Katia^1,2,3 

[1] Univ Bordeaux, EA4139, Lab Psychol, 3ter Pl Victoire, Bordeaux, France

[2] Ctr Hosp Charles Perrens, Pole 3-47,121 Rue Bechade, Bordeaux, France

[3] Fdn FondaMental, Reseau Ctr Expert Troubles Bipolaires, 40 Rue Mesly, Creteil, France

[4] Ctr Hosp Versailles, Serv Hosp Univ Psychiat Adultes & Addictol, 177 Rue Versailles, F-78157 Le Chesnay, France

[5] Univ Versailles St Quentin En Yvelines, Lab HANDIReSP, EA4047, 2 Ave Source Bievre, F-78180 Montigny Le Bretonneux, France

[6] Univ Paris Saclay, CESP, Team Dev Psychiat, 12 Ave Paul Vaillant Couturier, F-94807 Villejuif, France

关键词: Bipolar disorders;    Euthymia;    Remission;    Early maladaptive schemas (ems);    Person-oriented approach - recovery;   

DOI  :  10.1016/j.jad.2020.08.079

来源: Elsevier

【 摘 要 】

Background: A crucial health issue is to understand the remission heterogeneity of Bipolar Disorders by considering symptomatology as wel l as functioning. A new perspective could be elements of the construction of individual identity. This exploratory study aimed to explore the remission heterogeneity of patients with BD in terms of Early Maladaptive Schemas (EMS) by preferring a person-oriented approach. Methods: This study included euthymic patients recruited into the FACE-BD cohort. The remission was assessed by the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale for its symptomatic dimension and by the Functioning Assessment Short Test for its functional dimension. The activation of the eighteen EMS was assessed by the Young Schema Questionnaire 3 Short Form. Clusterin g was performed to identi f y profiles according to the patients' remission. Clusters identified were compared on the EMS activation by using analysis of variance and post-hoc tests. Results: Amongthe 100 euthymic patients included, fourprofiles ofremissionwere identified: cluster 1 Global Remission (34%), cluster 2 Hypomanic residual (20%), cluster 3 Depressive residual and functional impairment (36%) and cluster 4 Global handicap (10%). Two out of three EMS discriminated against these profiles. The activation of specific EMS clarifies the singularity of each remission profile. Limitations: For the symptomatic dimension, cut-offs chosen could be discussed as wel l as the scale assessing residual depressive symptoms. Conclusions: This study participates in a comprehensive model of remission by integrating the symptomatology, the functioning, and the EMS. Identifying and treating EMS may improve patients remission to reach recovery.

【 授权许可】

Free