New perspectives on coping in bipolar disorder.

Abstract

Bipolar disorder (BD) is a prevalent and highly disabling psychiatric condition. Despite the widely acknowledged importance of psychosocial interventions that involve a complex cognitive, behavioral, and biological process to help patients cope better with their illness, few studies have systematically evaluated coping in BD. Therefore, our objective was to examine recent developments in current research on coping in BD. Several studies have documented a strong association between BD and numerous neuroanatomical and neuropsychological abnormalities, particularly multiple episodes and longer durations of the disorder. The most marked effects of BD encompass brain areas involved in executive function, which may affect the mechanisms underlying an adequate selection of coping strategies. Thus, the ability of individuals to reduce their own stress burden is impaired, increasing vulnerability to stressful life events and negatively affecting the course of BD. Psychosocial interventions that focus on BD should be evaluated for their ability to improve coping abilities, and research on BD should consider neuropsychological impairment and cognitive-behavioral strategies for coping with stress.

Efficacy of Neuropsychological Rehabilitation Applied for Patients With Bipolar Disorder

“…Greenhouse et al (2000) have highlighted that coping strategies focused on low levels of acceptance and high levels of denial have been linked with poor medication adherence in bipolar I disorder, while maladaptive coping strategies, such as rumination about negative states, as shown in Nolen-Hoeksema (2000), are linked to increased depression. In accordance to those data, encouraging the development of a more adaptative coping strategies is one of the central components of a cognitive intervention in patients with BD, as suggested by Kapczinski et al (2008) and Grassi-Oliveira, Daruy-Filho, and Brietzke (2010). Based on this assumption, the coping was used in this study as a measure of efficacy of the NR protocol.…”

Psychosocial Interventions for Bipolar Disorder and Coping Style Modification: Similar Clinical Outcomes, Similar Mechanisms?

“…1 The cognitive dysfunction often accompanying BD may compromise adaptive coping, leading to further relapses and progressively worse cognitive impairment. 12 This illustrates the importance of explicitly teaching patients symptom identification and adaptive coping, as reflected in the common focus across interventions. Early detection has been suggested as a possible therapeutic ingredient for mania, 1 while early symptom detection and problem solving skills training have been suggested as key benefits of family-focused psychotherapy.…”

Childhood maltreatment and coping in bipolar disorder.

“…These facts can postulate the moderating role of coping between CMT and bipolar disorder progression. Thus, a new focus for psychosocial interventions may be introduced that is centered on readjusting coping strategies to relieve the progressive nature of the disorder (Grassi-Oliveira, Daruy-Filho, & Brietzke, 2010).…”

“…This impact is exerted through changes in immune, endocrine, and molecular mechanisms that modulate neuroplasticity (Bender, Alloy, Sylvia, Urosevic, & Abramson, 2010;GrassiOliveira et al, 2008;Kauer-Sant'Anna et al, 2007) and may be influenced by individual differences in stress responsivity. Interestingly, one's coping abilities may be impaired by the effects of stress mediators on relevant neurofunctional circuits (Grassi-Oliveira, Daruy-Filho, & Brietzke, 2010).…”