Abstract
Background
Maladaptive metacognitive beliefs are frequent during depressive states of bipolar disorder (BD). Still, it is unclear whether they persist in remitted phases and play a role in patients’ residual anxiety. The study aimed to investigate whether remitted patients with BD display maladaptive metacognitive beliefs, and whether these beliefs are associated with more residual anxiety and lower attention control.
Methods
Patients with BD in full remission (n = 28) and healthy control participants (HCs) (n = 31) were assessed with self-reported questionnaires measuring metacognitions, anxiety, attention, and a screening for cognitive impairment as well as two computerised attention tasks.
Results
Patients with BD exhibited higher levels of maladaptive metacognitive beliefs than HCs, also after adjustment for subsyndromal mood symptoms. Patients with BD also showed reduced attention control and cognitive impairments. Across the entire sample, more maladaptive metacognitive beliefs were associated with more anxiety symptoms, poorer cognition and lower attention control.
Conclusions
Maladaptive metacognitive beliefs are associated with residual anxiety in remitted patients with BD. Treatments that specifically target maladaptive metacognitive beliefs may have potential to reduce anxiety in remitted phases of BD and enhance patients’ functional recovery and quality of life.
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Data availability
Data is protected under local requirements and laws about data protection and cannot be shared. All data is archived in an anonymized format.
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Acknowledgements
We would like to thank our colleagues at the Psychiatric Centre Copenhagen, Copenhagen University Hospital for enabling recruitment of participants to the study and the Research Assistant on the project for their help with testing participants. We also wish to thank all participants for their time and effort. KWM holds a five-year Lundbeck Foundation Fellowship (Grant No. R215-2015-4121). There was no other funding for this specific study.
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All authors contributed to the study conception and design. Material preparation and data collection was performed by Ida Seeberg. Data extraction and analysis was performed by Ida Seeberg with help from Andreas Blicher and under close supervision from Kamilla Woznica Miskowiak. The first draft of the manuscript was written by Marie Louise Reinholdt-Dunne, Ida Seeberg and Kamilla Miskowiak, and all authors contributed to critical revision of the manuscript.
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The following authors declare the following financial interests which may be considered as potential competing interests: Maj Vinberg declares having received consultancy fee from Lundbeck, Janssen-Cilag and Sunovion the past three years; Lars Vedel Kessing declares having received consultancy fees from Lundbeck in the past three years; Kamilla Woznica Miskowiak declares having received consultancy fees from Lundbeck, Allergan and Janssen-Cilag in the past three years. The remaining authors (Marie Louise Reinholdt-Dunne, Ida Seeberg, Andreas Blicher, Nicoline Normann) declares having no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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The study was performed in accordance with the ethical standards of the local ethics committee (The Regional Committee, The Capital Region of Denmark: VEK) and with the 1964 Declaration of Helsinki and its later amendments. The local ethics committee stated that there was no need for approval, as the study did not involve any invasive or biomedical procedures (Journal No.: H-18063641).
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Reinholdt-Dunne, M.L., Seeberg, I., Blicher, A. et al. Residual Anxiety in Patients with Bipolar Disorder in Full or Partial Remission: Metacognitive Beliefs and Neurocognitive Function. Cogn Ther Res 45, 179–189 (2021). https://doi.org/10.1007/s10608-020-10148-7
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DOI: https://doi.org/10.1007/s10608-020-10148-7