Munuera Caroline, Compagnone Philippe, Gard Sébastien, Chevrier François, Chevrier Basilie, M'Bailara Katia
Université deBordeaux, Laboratoire de psychologie, Bordeaux, France.
Centre Hospitalier Charles Perrens, Pôle PGU, Bordeaux, France.
Br J Clin Psychol. 2025 Jun;64(2):513-538. doi: 10.1111/bjc.12519. Epub 2024 Dec 5.
Clinical heterogeneity is a major problem in mental health, referring to wide clinical variability among people with the same diagnosis. In bipolar disorders (BD), an heterogeneity was found both in global remission (symptomatic and functional) and in personal recovery during euthymia. This heterogeneity is a challenge for clinicians, who have to adapt their care to the individuals' characteristics. This preliminary study aimed at identifying profiles of experiences during euthymia by considering global remission (manic and depressive symptomatology, and functional impairment) and personal recovery, and exploring personal and contextual correlates associated with the heterogeneity of experiences.
A convenience sample of 58 participants in euthymia of BD was recruited. Data were collected using self-report questionnaires. Consistent with a person-oriented approach, clustering was performed to identify profiles by simultaneously considering symptomatology, functional impairment, and personal recovery. Associations between the identified profiles and socio-demographic, clinical, and family characteristics were explored using analysis of variance, Fisher's exact tests, and post hoc tests.
Five profiles were identified when considering both global remission and personal recovery: adverse experience (20.69%), slightly adverse experience (22.41%), unbalanced experience (10.34%), positive experience (22.14%), and hyperthymic positive experience (24.14%). Among the correlates, only current family functioning was significantly associated with the identified profiles through cohesion, communication, and satisfaction dimensions.
These results highlight that personal recovery and family dynamics of people with BD should be more considered in the clinical practice to better understand their experience during euthymia and adapt therapeutic care accordingly.
临床异质性是心理健康领域的一个主要问题,指的是患有相同诊断的人群中存在广泛的临床变异性。在双相情感障碍(BD)中,无论是在总体缓解(症状性和功能性)还是在心境正常期的个人康复方面都发现了异质性。这种异质性对临床医生来说是一个挑战,他们必须根据个体特征调整治疗。这项初步研究旨在通过考虑总体缓解(躁狂和抑郁症状以及功能损害)和个人康复来确定心境正常期的经历概况,并探索与经历异质性相关的个人和背景因素。
招募了58名处于BD心境正常期的参与者作为便利样本。使用自我报告问卷收集数据。与以人为本的方法一致,通过同时考虑症状、功能损害和个人康复进行聚类以识别概况。使用方差分析、费舍尔精确检验和事后检验探索所确定的概况与社会人口统计学、临床和家庭特征之间的关联。
在同时考虑总体缓解和个人康复时,确定了五种概况:不良经历(20.69%)、轻度不良经历(22.41%)、不平衡经历(10.34%)、积极经历(22.14%)和精神饱满的积极经历(24.14%)。在相关因素中,只有当前家庭功能通过凝聚力、沟通和满意度维度与所确定的概况显著相关。
这些结果表明,在临床实践中应更多地考虑BD患者的个人康复和家庭动态,以便更好地理解他们在心境正常期的经历并相应地调整治疗护理。