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

[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.

[发布日期] 2020-12-01

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