OBJECTIVES: Low self-esteem has been found to be a risk factor for depression in major depressive disorder (MDD). In contrast, the role of self-esteem in bipolar disorder (BD) is still uncertain. In order to examine the characteristics of self-esteem in BD, we synthesized studies comparing self-esteem in BD patients with self-esteem in MDD patients and in normal controls. METHODS: Database searches and identification of studies were conducted by two of the authors independently. Remission of BD and MDD was a major selection criterion. The results were generated through meta-analyses. RESULTS: Random-effects models of 19 between-group comparisons (N= 1,838) suggested that the self-esteem of remitted BD patients was significantly lower than that of normal controls (Cohen's d= -0.83), while significantly higher than that of remitted MDD patients (Cohen's d= 0.54). Fail-safe numbers and tests for funnel plot asymmetry indicated that the results were robust and unlikely to reflect publication biases. Additional studies indicated that self-esteem may take a fluctuating course during remission of BD. CONCLUSIONS: By revealing that BD patients do experience low self-esteem, the findings implicate a need for further understanding the causes and therapeutic impact of such abnormality in BD.
OBJECTIVES: Low self-esteem has been found to be a risk factor for depression in major depressive disorder (MDD). In contrast, the role of self-esteem in bipolar disorder (BD) is still uncertain. In order to examine the characteristics of self-esteem in BD, we synthesized studies comparing self-esteem in BDpatients with self-esteem in MDDpatients and in normal controls. METHODS: Database searches and identification of studies were conducted by two of the authors independently. Remission of BD and MDD was a major selection criterion. The results were generated through meta-analyses. RESULTS: Random-effects models of 19 between-group comparisons (N= 1,838) suggested that the self-esteem of remitted BDpatients was significantly lower than that of normal controls (Cohen's d= -0.83), while significantly higher than that of remitted MDDpatients (Cohen's d= 0.54). Fail-safe numbers and tests for funnel plot asymmetry indicated that the results were robust and unlikely to reflect publication biases. Additional studies indicated that self-esteem may take a fluctuating course during remission of BD. CONCLUSIONS: By revealing that BDpatients do experience low self-esteem, the findings implicate a need for further understanding the causes and therapeutic impact of such abnormality in BD.
Authors: Chaya B Gopin; Katherine E Burdick; Pamela Derosse; Terry E Goldberg; Anil K Malhotra Journal: Bipolar Disord Date: 2011-03 Impact factor: 6.744