Early maladaptive schemas and functional impairment in remitted bipolar disorder patients

Background and objectivesPrevious research indicates that low self-esteem is associated with functional impairment in remitted bipolar disorder patients. The present study aimed to elucidate this area further by exploring the relationship between different self-schemas and key functional outcome domains.MethodsThe study consisted of 49 remitted bipolar disorders patients who completed the Young Schema Questionnaire - Short Version (YSQ-S3) and the Work and Social Adjustment Scale (WSAS).ResultsA hierarchical regression analysis revealed that the schemas Social Isolation, Failure to Achieve, Dependence, Vulnerability to Harm and Illness, Emotional Inhibition, Insufficient Self-Control, and Pessimism accounted for 28% of the variance in functional impairment when controlling for length of remission and subsyndromal depressive symptoms.LimitationsThe WSAS as a self-report scale measures the patients' perception of own functioning and is therefore not an objective measure of functioning.ConclusionsThe findings delineate specific psychological vulnerabilities which are likely to be implicated in functional impairment in bipolar disorder and as such warrant further examination in terms of their causal mechanisms and therapeutic implications.

► Early maladaptive schemas are proposed to play a role in functional impairment. ► Several early maladaptive schemas correlated significantly with functional impairment. ► Seven early maladaptive schemas accounted for 28% of the variance in functional impairment.