Extreme appraisals of internal states and length of remission in remitted bipolar patients

Objective: Identifying dysfunctional attitudes seen in Bipolar Disorder (BPD) is important for cognitive theories of BPD and corresponding psychosocial interventions. Cognitions are seen as vulnerability factors in the development and maintenance of bipolar disorder. The present study aims to contribute to the cognitive literature on BPD by examining depressive and hypomanic attitudes and their contribution to prediction of bipolar disorder diagnosis, and also by exploring the relationship between dysfunctional cognitions and clinical features (types of episodes experienced, length of illness and length of remission). Method: 118 remitted bipolar patients and 103 healthy controls completed the Mood Disorder Questionnaire, the Turkish Brief-HAPPI and the Dysfunctional Attitudes Scale. Results: The bipolar group had significantly higher depressive and hypomanic attitudes than the control group. No significant differences were found regarding types of episodes experienced and length of illness. However both types of attitudes decreased as the length of remission increased. They were also found to contribute to the prediction of bipolar diagnosis together with the screening of the Mood Disorder Questionnaire. Conclusion: The results pointed out that dysfunctional cognitions may be utilized as possible indicators of risk for relapse in clinical groups and of vulnerability for bipolar disorder among other populations.