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The influence of successful prophylactic drug treatment on cognitive dysfunction in bipolar disorders
Author(s) -
Wolf Thomas,
MüllerOerlinghausen Bruno
Publication year - 2002
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1034/j.1399-5618.2002.00136.x
Subject(s) - bipolar disorder , dysfunctional family , psychology , mood , context (archaeology) , psychiatry , depression (economics) , bipolar i disorder , mood stabilizer , carbamazepine , cognition , major depressive episode , clinical psychology , analysis of variance , mood disorders , mania , medicine , anxiety , paleontology , macroeconomics , economics , epilepsy , biology
Background: Cognitive variables such as negative self‐evaluations have been discussed as vulnerability factors for depressive syndromes. In the context of bipolar disorders dysfunctional cognitive structures have received little interest as these patients seem to be less disturbed during the euthymic interval than patients with major depression.Methods: In the present study, the self‐esteem of remitted patients with DSM‐III‐R diagnosis of major depression (n=20), bipolar disorder (n=20) and healthy controls (n=20) was measured with the Frankfurt Self‐concept Scale (FSKN).Results: 1) Statistical analysis by analysis of variance (ANOVA) showed no significant differences as to age, sex, etc. between the psychiatric groups. The clinical groups showed lower self‐esteem ratings in comparison to healthy controls. 2) Four groups (T1–T4) of remitted patients with bipolar disorders (20 in each group) were successfully maintained on mood stabilizers (lithium or carbamazepine) and classified by the duration of their episode‐free period. T1 included those who were episode‐free for only the week before discharge from hospital. T2 were symptom‐free for <30 months. T3 were episode‐free for >30 months and <60 months. T4 were episode‐free for >60 months. The comparison of their FSKN self‐esteem ratings by ANOVA suggests that self‐esteem improves during successful prophylactic treatment. A posteriori contrasts indicate a normalized self‐esteem after a bipolar episode‐free period of at least 47 months.Conclusions: Dysfunctional cognitions can be demonstrated in unipolar as well as in bipolar patients. Successful episode‐preventive medication with mood stabilizers seems to counteract lowered self‐esteem. Adjunctive cognitive therapy might help to optimize the long‐term course of bipolar disorder.