Caroline Munuera1, Paul Roux2, François Weil3, Christine Passerieux2, Katia M'Bailara4. 1. Laboratoire de psychologie, EA4139, Université́ de Bordeaux, 3ter place de la Victoire, Bordeaux, France. 2. Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux; CESP, Team "Developmental Psychiatry", Université Paris-Saclay, Inserm, 12 Avenue Paul Vaillant Couturier, 94807, Villejuif. 3. Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France; Service Hospitalo-Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France; Laboratoire HANDIReSP, EA4047, Université de Versailles Saint-Quentin-En-Yvelines, 2 Avenue de la Source de la Bièvre, 78180 Montigny-le-Bretonneux. 4. Laboratoire de psychologie, EA4139, Université́ de Bordeaux, 3ter place de la Victoire, Bordeaux, France; Centre Hospitalier Charles Perrens, Pôle 3-4-7, Bordeaux, 121 rue de la Béchade, Bordeaux, France; Réseau des Centres Expert des Troubles Bipolaires, Fondation FondaMental, 40 rue de Mesly, Créteil, France. Electronic address: katia.mbailara@u-bordeaux.fr.
Abstract
BACKGROUND: A crucial health issue is to understand the remission heterogeneity of Bipolar Disorders by considering symptomatology as well as functioning. A new perspective could be elements of the construction of individual identity. This exploratory study aimed to explore the remission heterogeneity of patients with BD in terms of Early Maladaptive Schemas (EMS) by preferring a person-oriented approach. METHODS: This study included euthymic patients recruited into the FACE-BD cohort. The remission was assessed by the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale for its symptomatic dimension and by the Functioning Assessment Short Test for its functional dimension. The activation of the eighteen EMS was assessed by the Young Schema Questionnaire 3 Short Form. Clustering was performed to identify profiles according to the patients' remission. Clusters identified were compared on the EMS activation by using analysis of variance and post-hoc tests. RESULTS: Among the 100 euthymic patients included, four profiles of remission were identified: cluster 1 "Global Remission" (34%), cluster 2 "Hypomanic residual" (20%), cluster 3 "Depressive residual and functional impairment" (36%) and cluster 4 "Global handicap" (10%). Two out of three EMS discriminated against these profiles. The activation of specific EMS clarifies the singularity of each remission profile. LIMITATIONS: For the symptomatic dimension, cut-offs chosen could be discussed as well as the scale assessing residual depressive symptoms. CONCLUSIONS: This study participates in a comprehensive model of remission by integrating the symptomatology, the functioning, and the EMS. Identifying and treating EMS may improve patients remission to reach recovery.
BACKGROUND: A crucial health issue is to understand the remission heterogeneity of Bipolar Disorders by considering symptomatology as well as functioning. A new perspective could be elements of the construction of individual identity. This exploratory study aimed to explore the remission heterogeneity of patients with BD in terms of Early Maladaptive Schemas (EMS) by preferring a person-oriented approach. METHODS: This study included euthymic patients recruited into the FACE-BD cohort. The remission was assessed by the Montgomery-Asberg Depression Rating Scale and the Young Mania Rating Scale for its symptomatic dimension and by the Functioning Assessment Short Test for its functional dimension. The activation of the eighteen EMS was assessed by the Young Schema Questionnaire 3 Short Form. Clustering was performed to identify profiles according to the patients' remission. Clusters identified were compared on the EMS activation by using analysis of variance and post-hoc tests. RESULTS: Among the 100 euthymic patients included, four profiles of remission were identified: cluster 1 "Global Remission" (34%), cluster 2 "Hypomanic residual" (20%), cluster 3 "Depressive residual and functional impairment" (36%) and cluster 4 "Global handicap" (10%). Two out of three EMS discriminated against these profiles. The activation of specific EMS clarifies the singularity of each remission profile. LIMITATIONS: For the symptomatic dimension, cut-offs chosen could be discussed as well as the scale assessing residual depressive symptoms. CONCLUSIONS: This study participates in a comprehensive model of remission by integrating the symptomatology, the functioning, and the EMS. Identifying and treating EMS may improve patients remission to reach recovery.