Goldberg Joseph F, Gerstein Rachel K, Wenze Susan J, Welker Tara M, Beck Aaron T
Affective Disorders Research Program, Silver Hill Hospital, New Canaan, Connecticut, USA.
J Nerv Ment Dis. 2008 Mar;196(3):207-10. doi: 10.1097/NMD.0b013e3181663015.
Dysfunctional thought patterns are presumed to underlie cognitive biases in mood disorder patients. However, few studies have compared dysfunctional thought patterns in bipolar manic and unipolar depressed patients. Cognitive schemas and dysfunctional attitudes were evaluated using the cognitive checklist for mania and Dysfunctional Attitudes Scale (DAS) in 34 bipolar manic, 35 unipolar depressed, and 29 nonpsychiatric control subjects. Unipolar depressed subjects had significantly higher total DAS scores and subfactor scores as compared with nonpsychiatric controls, whereas bipolar patients had intermediate scores between both groups. Significant correlations emerged between cognitive checklist for mania total and subcomponent scores and the DAS (total, performance subfactor, and approval subfactor scales) for the bipolar, but not the unipolar or nonpsychiatric control groups. Core beliefs among bipolar patients appear negativistic during manic phases, potentially reflecting an overcompensation for depression. The findings support clinical approaches targeting depressive cognitions regardless of the presence of manic symptoms.
功能失调的思维模式被认为是情绪障碍患者认知偏差的潜在原因。然而，很少有研究比较双相躁狂患者和单相抑郁患者的功能失调思维模式。使用躁狂认知检查表和功能失调态度量表（DAS）对34名双相躁狂患者、35名单相抑郁患者和29名非精神科对照者进行认知图式和功能失调态度评估。与非精神科对照者相比，单相抑郁患者的DAS总分和子因子得分显著更高，而双相患者的得分介于两组之间。双相患者组中，躁狂认知检查表总分及子成分得分与DAS（总分、表现子因子和认可子因子量表）之间存在显著相关性，而单相抑郁患者组和非精神科对照者组则不存在。双相患者在躁狂发作期的核心信念似乎是否定的，这可能反映了对抑郁的过度补偿。这些发现支持了针对抑郁认知的临床方法，无论是否存在躁狂症状。
