CADE Clinic, Department of Psychiatry, Royal North Shore Hospital, Sydney, Australia.
J Affect Disord. 2013 Feb 15;145(1):54-61. doi: 10.1016/j.jad.2012.07.012. Epub 2012 Aug 23.
Euthymic bipolar disorder (BD) patients often demonstrate better clinical outcomes than remitted patients with unipolar illness (UP). Reasons for this are uncertain, however, personality and coping styles are each likely to play a key role. This study examined differences between euthymic BD and UP patients with respect to the inter-relationship between personality, coping style, and clinical outcomes.
A total of 96 UP and 77 BD euthymic patients were recruited through the CADE Clinic, Royal North Shore Hospital in Sydney, and assessed by a team comprising Psychiatrists and Psychologists. They underwent a structured clinical diagnostic interview, and completed self-report measures of depression, anxiety, stress, personality, coping, social adjustment, self-esteem, dysfunctional attitudes, and fear of negative evaluation.
Compared to UP, BD patients reported significantly higher scores on levels of extraversion, adaptive coping, self-esteem, and lower scores on trait anxiety and fear of negative evaluation. Extraversion correlated positively with self-esteem, adaptive coping styles, and negatively with trait anxiety and fear of negative evaluation. Trait anxiety and fear of negative evaluation correlated positively with eachother, and both correlated negatively with self-esteem and adaptive coping styles. Finally, self-esteem correlated positively with adaptive coping styles.
The results cannot be generalised to depressive states of BD and UP, as differences in the course of illness and types of depression are likely to impact on coping and clinical outcomes, particularly for BD.
During remission, functioning is perhaps better 'preserved' in BD than in UP, possibly because of the protective role of extraversion which drives healthier coping styles.
与单相情感障碍(UP)缓解期患者相比,双相情感障碍(BD)缓解期患者的临床结局通常更好。然而,其原因尚不确定,但是人格和应对方式可能都起着关键作用。本研究旨在探讨双相情感障碍缓解期与单相情感障碍缓解期患者在人格、应对方式与临床结局的相互关系方面存在的差异。
本研究共纳入了 96 名单相情感障碍缓解期患者和 77 名双相情感障碍缓解期患者,这些患者均来自悉尼皇家北岸医院的 CADE 诊所,由一组精神病医生和心理学家进行评估。他们接受了结构化的临床诊断访谈,并完成了抑郁、焦虑、压力、人格、应对方式、社会适应、自尊、功能失调态度和负面评价恐惧的自我报告量表评估。
与 UP 相比,BD 患者的外向性、适应性应对方式、自尊得分显著较高,而特质焦虑和负面评价恐惧得分显著较低。外向性与自尊、适应性应对方式呈正相关,与特质焦虑和负面评价恐惧呈负相关。特质焦虑和负面评价恐惧呈正相关,与自尊和适应性应对方式呈负相关。最后,自尊与适应性应对方式呈正相关。
本研究结果不能推广到 BD 和 UP 的抑郁状态,因为疾病过程和抑郁类型的差异可能会影响应对方式和临床结局,尤其是对于 BD。
在缓解期,BD 的功能可能比 UP 更好地“保持”,这可能是因为外向性起到了保护作用,从而驱动了更健康的应对方式。