Are dysfunctional attitudes elevated and linked to mood in bipolar disorder? A systematic review and meta‐analysis

Objectives Dysfunctional attitudes (DA) are higher in depression; however, less is understood about their role in bipolar disorder (BD). This paper aimed to explore the presence of DA in BD in comparison to clinical and non‐clinical groups. Also explored were the associations between DA and mood sta...

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Bibliographic Details
Published in:British journal of clinical psychology 2024-03, Vol.63 (1), p.16-53
Main Authors: Woods, Chloe, Richardson, Thomas, Palmer‐Cooper, Emma
Format: Article
Language:English
Subjects:
Affect - physiology
Attitude
Attitudes
bipolar
Bipolar disorder
Bipolar Disorder - psychology
depression
dysfunctional attitudes
Humans
Mania
Mental depression
Meta-analysis
mood
Systematic review
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Summary:Objectives Dysfunctional attitudes (DA) are higher in depression; however, less is understood about their role in bipolar disorder (BD). This paper aimed to explore the presence of DA in BD in comparison to clinical and non‐clinical groups. Also explored were the associations between DA and mood states of depression, mania or euthymia in BD. Methods A systematic review and meta‐analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta‐analysis. The quality of each study was rated. Results The meta‐analysis showed significantly higher DA in BD than healthy controls (d = .70). However, no difference was observed between BD and unipolar participants (d = −.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (d = −.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d = −.38). Conclusions These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go ‘offline’ when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice‐based implications are expanded on in the discussion.
ISSN:0144-6657
2044-8260
DOI:10.1111/bjc.12442