Rumination in bipolar disorder: a systematic review

Abstract

Objective: To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD). Methods: We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors ''rumination'' and ''bipolar disorder'' and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review. Results: Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD. Conclusions: Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.

Emotion regulation strategies in bipolar disorder: A systematic and critical review

“…Findings across case-control studies suggest that participants with BD endorse putatively maladaptive strategies for regulating negative affect such as rumination, selfblame, suppression and catastrophising more strongly than non-clinical controls, but have a similar ER profile to people with UPD. This is in line with existing literature that suggests certain ER strategies, particularly rumination, are related to psychopathology (Aldao et al, 2010;Ehring & Watkins, 2008;Silveira & Kauer-Sant'Anna, 2015). Overall, evidence suggested that people with BD did not have difficulties responding to negative affect with acceptance, problem-solving, reappraisal and distraction, which the literature suggests are adaptive in relation to psychopathology (Aldao et al, 2010).…”

Repetitive Negative Thinking and Eating Disorders: A Meta-Analysis of the Role of Worry and Rumination

“…Worry is associated with anxiety disorders [ 9 , 10 , 11 , 12 ] and major depressive disorder [ 13 , 14 , 15 ]. Rumination is associated with both the development and persistence of mood and anxiety disorders [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], addictive behaviours [ 25 , 26 ], and schizophrenia [ 27 ].…”

Feasibility and Acceptability of the ‘HABIT’ Group Programme for Comorbid Bipolar and Alcohol and Substance use Disorders

“…These symptoms can be partially ameliorated by pharmacotherapy, but it is increasingly clear that psychological interventions, especially cognitive, behavioural or self-regulation approaches, may be more efficient (McMurrich et al, 2012;Naqvi et al, 2015;Strickland, Reynolds, & Stoops, 2016). Also, symptoms of BD and ASUD may all be precipitated or maintained by dysfunctional cognitive emotional regulation (CER), particularly a negative ruminative response style (Gruber et al, 2011;Caselli et al, 2013;de Silveira & Kauer-Sant'Anna, 2015;Grierson et al, 2016). The exacerbation of mood disorder or ASUD may be, in part, driven by negative rumination.…”