Determinants of the remission heterogeneity in bipolar disorders: the importance of early maladaptive schemas (EMS)
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Article de revue
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Journal of Affective Disorders. 2020-09-01p. 12392
Resumen en inglés
Background: A crucial health issue is to understand the remission heterogeneity of Bipolar Disorders by con-
sidering symptomatology as well as functioning. A new perspective could be elements of the construction ...Leer más >
Background: A crucial health issue is to understand the remission heterogeneity of Bipolar Disorders by con-
sidering symptomatology as well 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. Clustering was performed to
identify profiles according to the patients’ remission. Clusters identified were compared on the EMS activation by
using analysis of variance and post-hoc tests.
Results: Among the 100 euthymic patients included, four profiles of remission were identified: cluster 1 “Global
Remission” (34%), cluster 2 “Hypomanic residual” (20%), cluster 3 “Depressive residual and functional im-
pairment” (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 well 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.< Leer menos
Palabras clave en inglés
Bipolar disorders
Euthymia
Remission
Early maladaptive schemas (ems)
Person-oriented approach - recovery
Centros de investigación