Previous research has indicated that cognitive dysfunction is common in affective disorders. However, bipolar disorder has not received as much attention as major depression because less severe symptoms are generally observed during remission periods in the former condition.

Drs Thomas Wolf and Bruno Müller-Oerlinghausen, from the District Hospital of Itzehoe and the Free University of Berlin, respectively, investigated the levels of self-esteem among a group of 20 bipolar disorder patients who were in remission and compared the results to those obtained from 20 patients with major depression and healthy controls.

Self-esteem was measured in the 40 individuals using the Frankfurt Self-concept Scale.

The researchers found that both the depressed patients and those with bipolar disorder had significantly lower self-esteem levels than the healthy controls.

An additional study of solely bipolar patients showed a correlation between levels of self-esteem and duration of remission. Remitted bipolar patients who had been successfully treated with mood stabilizers were divided into groups on the basis of remission duration (one week, less than 30 months, between 30 and 60 months, and over 60 months).

Self-esteem levels were found to improve with duration of remission, and the researchers estimated that levels return to normal after around 47 months of remission.

Drs Wolf and Müller-Oerlinghausen conclude that dysfunctional cognition is common in bipolar patients, but that lowered self-esteem may be treated with effective mood stabilization.

They add that cognitive therapy may be a valuable adjunct to treatment for this patient group.

Reference: Wolf T and Müller-Oerlinghausen B, Bipolar Disorders 2002;4:263-270

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