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Major depressive disorder (MDD) was previously associated with negative affective biases. Evidence from larger population-based studies, however, is lacking, including whether biases normalise with remission. We investigated associations between affective bias measures and depressive symptom severity across a large community-based sample, followed by examining differences between remitted individuals and controls.
Methods
Participants from Generation Scotland (N = 1109) completed the: (i) Bristol Emotion Recognition Task (BERT), (ii) Face Affective Go/No-go (FAGN), and (iii) Cambridge Gambling Task (CGT). Individuals were classified as MDD-current (n = 43), MDD-remitted (n = 282), or controls (n = 784). Analyses included using affective bias summary measures (primary analyses), followed by detailed emotion/condition analyses of BERT and FAGN (secondary analyses).
Results
For summary measures, the only significant finding was an association between greater symptoms and lower risk adjustment for CGT across the sample (individuals with greater symptoms were less likely to bet more, despite increasingly favourable conditions). This was no longer significant when controlling for non-affective cognition. No differences were found for remitted-MDD v. controls. Detailed analysis of BERT and FAGN indicated subtle negative biases across multiple measures of affective cognition with increasing symptom severity, that were independent of non-effective cognition [e.g. greater tendency to rate faces as angry (BERT), and lower accuracy for happy/neutral conditions (FAGN)]. Results for remitted-MDD were inconsistent.
Conclusions
This suggests the presence of subtle negative affective biases at the level of emotion/condition in association with depressive symptoms across the sample, over and above those accounted for by non-affective cognition, with no evidence for affective biases in remitted individuals.
Bipolar disorder is presumed to involve difficulties in emotion regulation. However, little is known about the specific emotion regulation profile associated with this disorder.
Objectives
To study emotion regulation in bipolar patients in remission phase and to determine the factors correlated with it.
Methods
A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker University Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Cognitive Emotion Regulation Questionnaire (CERQ) which assesses cognitive strategies (maladaptive and adaptive) for regulating emotion.
Results
The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. A good adherence to treatment was found in 86.7% of cases and a good social integration in 40%. The mean total score of the adaptive CERQ was 66.73 and the most used adaptive strategy was acceptation (mean score =13.87), while the mean total score of the maladaptive CERQ was 36.7 and the most used maladaptive strategy was self blame (mean score =9.47). Adaptive cognitive emotion regulation was predominant in 93.3% of patients. It was significantly correlated with good adherence to treatment (p = 0.047) and good social integration (p = 0.026).
Conclusions
Our patients with euthymic bipolar disorder showed a satisfying level of adaptive emotion regulation strategies. A cognitive remediation seems important to embetter this capacity and improve the income of the disease.
The influence of personality on how people deal with stressful situations has long been discussed. In bipolar disorder, these two entities seem to have a role in the outcome of the disease.
Objectives
To study the relationships between coping strategies in stressful situations and personality dimensions in euthymic bipolar patients.
Methods
This is a cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder in remission, at the psychiatric outpatient clinic at the Hédi Chaker Uuniversity Hospital in Sfax. We used a socio-demographic and clinical data sheet and the Ten Items Personality Inventory (TIPI) to evaluate personality dimensions and the Ways Of Coping Checklist (WWC) for the assessment of coping.
Results
The mean age of the patients was 43.77 years, the sex ratio was 0.5. Bipolar I disorder was diagnosed in 93% of patients. WCC : -Coping focused on the problem : 70% of the patients. -Emotion-centered coping : 20% of patients -Coping focused on seeking social support : 10% of patients. TIPI : Conciousness was the most represented trait of personality (36.7%), agreableness (30%) and extraversion (20%). Extraversion was associated with coping focused on the problem: (p=0.015). Agreableness was associated with coping focused on seeking social support:(p=0.033).
Conclusions
Our study showed that conciousness is the most common trait of personality in bipolar disorder patients. The coping focused on the problem is the most frequent strategy which correlated with extraversion, so, personality dimensions appear as a target for cognitive interventions.
Impulsivity is an important component of the phenomenology of bipolar disorder. Recent studies show that bipolar patients use various strategies to deal with life stressors and with the discomfort related to their disease.
Objectives
To study impulsivity and coping strategies in bipolar patients in remission phase and the factors associated with them.
Methods
A cross-sectional, descriptive and analytical study of 30 patients followed for bipolar disorder, in remission, at the psychiatric outpatient clinic at CHU Hédi Chaker in Sfax. We used a socio-demographic and clinical data sheet, the Ways Of Coping Checklist to assess coping and the Barratt Impulsivity Scale to assess impulsivity.
Results
The average age was 43.77 years, the sex ratio was 0.5. Smoking was found in 30%. Bipolar I disorder was diagnosed in 93% of patients. The mean age of onset was 27.8 years, and the mean duration of illness was 15 years. *Impulsivity was found in 20% of cases and was correlated with the duration of the disease (p = 0.016) and smoking (p = 0.009). *Coping focused on the problem present in 70% of patients, correlated with the duration of the disease (p = 0.032) and coping (p=0.02). *Emotion-centered coping revealed in 20% of patients, correlated with gender (p = 0.037) and cognitive impulsivity (p=0.032). *Coping focused on seeking social support was present in 10% of patients.
Conclusions
Impulsivity is quite frequent in remitted bipolar patients, who mainly used problem-focused coping and a cognitive management of the stressful event. Thus the hypothesis was that impulsivity is core trait of bipolar disorder.
Eighty percent of all patients suffering from major depressive disorder (MDD) relapse at least once in their lifetime. Thus, understanding the neurobiological underpinnings of the course of MDD is of utmost importance. A detrimental course of illness in MDD was most consistently associated with superior longitudinal fasciculus (SLF) fiber integrity. As similar associations were, however, found between SLF fiber integrity and acute symptomatology, this study attempts to disentangle associations attributed to current depression from long-term course of illness.
Methods
A total of 531 patients suffering from acute (N = 250) or remitted (N = 281) MDD from the FOR2107-cohort were analyzed in this cross-sectional study using tract-based spatial statistics for diffusion tensor imaging. First, the effects of disease state (acute v. remitted), current symptom severity (BDI-score) and course of illness (number of hospitalizations) on fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity were analyzed separately. Second, disease state and BDI-scores were analyzed in conjunction with the number of hospitalizations to disentangle their effects.
Results
Disease state (pFWE < 0.042) and number of hospitalizations (pFWE< 0.032) were associated with decreased FA and increased MD and RD in the bilateral SLF. A trend was found for the BDI-score (pFWE > 0.067). When analyzed simultaneously only the effect of course of illness remained significant (pFWE < 0.040) mapping to the right SLF.
Conclusions
Decreased FA and increased MD and RD values in the SLF are associated with more hospitalizations when controlling for current psychopathology. SLF fiber integrity could reflect cumulative illness burden at a neurobiological level and should be targeted in future longitudinal analyses.
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