Batmaz Sedat, Ulusoy Kaymak Semra, Kocbiyik Sibel, Turkcapar Mehmet Hakan
Psychiatry Clinic, Mersin State Hospital, Mersin, Turkey.
Psychiatry Clinic, Ataturk Training and Research Hospital, Ankara, Turkey.
Compr Psychiatry. 2014 Oct;55(7):1546-55. doi: 10.1016/j.comppsych.2014.05.016. Epub 2014 Jun 2.
Clinicians need to make the differential diagnosis of unipolar and bipolar depression to guide their treatment choices. Looking at the differences observed in the metacognitions, and the emotional schemas, might help with this differentiation, and might provide information about the distinct psychotherapeutical targets.
Three groups of subjects (166 unipolar depressed, 140 bipolar depressed, and 151 healthy controls) were asked to fill out the Metacognitions Questionnaire-30 (MCQ-30), and the Leahy Emotional Schema Scale (LESS). The clinicians diagnosed the volunteers according to the criteria of DSM-IV-TR with a structured clinical interview (MINI), and rated the moods of the subjects with the Montgomery Asberg Depression Rating Scale (MADRS), and the Young Mania Rating Scale (YMRS). Statistical analyses were undertaken to identify the group differences on the MCQ-30, and the LESS.
The bipolar and unipolar depressed patients' scores on the MCQ-30 were significantly different from the healthy controls, but not from each other. On the LESS dimensions of guilt, duration, blame, validation, and acceptance of feelings, all three groups significantly differed from each other. There were no statistically different results on the LESS dimensions of comprehensibility, consensus, and expression. The mood disordered groups scored significantly different than the healthy controls on the LESS dimensions of simplistic view of emotions, numbness, rationality, rumination, higher values, and control.
These results suggest that the metacognitive model of unipolar depression might be extrapolated for patients with bipolar depression. These results are also compatible to a great extent with the emotional schema theory of depression.
临床医生需要对单相抑郁和双相抑郁进行鉴别诊断，以指导治疗方案的选择。观察元认知和情绪图式中存在的差异，可能有助于这种鉴别，并可能提供有关不同心理治疗靶点的信息。
三组受试者（166名单相抑郁患者、140名双相抑郁患者和151名健康对照者）被要求填写元认知问卷-30（MCQ-30）和利ahy情绪图式量表（LESS）。临床医生根据DSM-IV-TR标准，通过结构化临床访谈（MINI）对志愿者进行诊断，并用蒙哥马利-阿斯伯格抑郁评定量表（MADRS）和杨氏躁狂评定量表（YMRS）对受试者的情绪进行评分。进行统计分析以确定MCQ-30和LESS上的组间差异。
双相抑郁和单相抑郁患者在MCQ-30上的得分与健康对照者有显著差异，但彼此之间无显著差异。在LESS的内疚、持续时间、责备、验证和情感接纳维度上，三组之间均存在显著差异。在LESS的可理解性、一致性和表达维度上，未得出有统计学差异的结果。情绪障碍组在LESS的情绪简单化观点、麻木、理性、沉思、更高价值观和控制维度上的得分与健康对照者有显著差异。
这些结果表明，单相抑郁的元认知模型可能适用于双相抑郁患者。这些结果在很大程度上也与抑郁的情绪图式理论相符。
