School of Psychiatry, University of New South Wales, Randwick, NSW, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia.
J Affect Disord. 2013 Dec;151(3):1016-24. doi: 10.1016/j.jad.2013.08.029. Epub 2013 Sep 6.
Previous reports have highlighted perfectionism and related cognitive styles as a psychological risk factor for stress and anxiety symptoms as well as for the development of bipolar disorder symptoms. The anxiety disorders are highly comorbid with bipolar disorder but the mechanisms that underpin this comorbidity are yet to be determined.
Measures of depressive, (hypo)manic, anxiety and stress symptoms and perfectionistic cognitive style were completed by a sample of 142 patients with bipolar disorder. Mediation models were used to explore the hypotheses that anxiety and stress symptoms would mediate relationships between perfectionistic cognitive styles, and bipolar disorder symptoms.
Stress and anxiety both significantly mediated the relationship between both self-critical perfectionism and goal attainment values and bipolar depressive symptoms. Goal attainment values were not significantly related to hypomanic symptoms. Stress and anxiety symptoms did not significantly mediate the relationship between self-critical perfectionism and (hypo)manic symptoms.
These findings highlight a plausible mechanism to understand the relationship between bipolar disorder and the anxiety disorders. Targeting self-critical perfectionism in the psychological treatment of bipolar disorder when there is anxiety comorbidity may result in more parsimonious treatments.
先前的报告强调了完美主义和相关的认知风格是压力和焦虑症状以及双相情感障碍症状发展的心理风险因素。焦虑障碍与双相情感障碍高度共病，但支撑这种共病的机制尚未确定。
通过对 142 名双相情感障碍患者进行抑郁、（轻）躁狂、焦虑和压力症状以及完美主义认知风格的测量，采用中介模型来验证以下假设：焦虑和压力症状将在完美主义认知风格与双相情感障碍症状之间的关系中起中介作用。
压力和焦虑都显著地在自我批判完美主义和目标达成价值与双相抑郁症状之间起中介作用。目标达成价值与轻躁狂症状没有显著相关。自我批判完美主义与（轻）躁狂症状之间的关系没有通过压力和焦虑症状来介导。
这些发现突出了一种可以理解双相情感障碍与焦虑障碍之间关系的可能机制。当存在焦虑共病时，在双相情感障碍的心理治疗中针对自我批判完美主义，可能会导致更简洁的治疗方法。
