Rumination in major depressive and bipolar disorder – a meta-analysis

Kovács, Lilla Nóra; Takács, Zsófia K.; Tóth, Zsófia; Simon, Evelin; Schmelowszky, Ágoston; Kökönyei, Gyöngyi

doi:10.1016/j.jad.2020.07.131

Cited by 54 publications

(36 citation statements)

References 66 publications

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“…The finding from the present RADMIS trial that smartphone‐based monitoring and treatment may reduce the level of rumination is interesting. A recent meta‐analysis found rumination, reflecting repetitive thoughts about emotionally relevant experiences, to be a significant process in bipolar disorder, 55 highlighting the importance of interventions to reduce rumination in bipolar disorder. Furthermore, concerning the treatment of residual depression, rumination‐focused cognitive therapy and concreteness training (a facilitated self‐help intervention for increasing specificity of processing in patients with depression) have shown encouraging results 16 …”

Section: Discussionmentioning

confidence: 99%

Reducing the rate of psychiatric re‐admissions in bipolar disorder using smartphones—The RADMIS trial

Faurholt‐Jepsen

Tønning

Fros³

et al. 2021

Acta Psychiatr Scand

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Objectives:The MONARCA I and II trials were negative but suggested that smartphone-based monitoring may increase quality of life and reduce perceived stress in bipolar disorder (BD). The present trial was the first to investigate the effect of smartphone-based monitoring on the rate and duration of readmissions in BD. Methods: This was a randomized controlled single-blind parallel-group trial. Patients with BD (ICD-10) discharged from hospitalization in the Mental Health Services, Capital Region of Denmark were randomized 1:1 to daily smartphone-based monitoring including a feedback loop (+ standard treatment) or to standard treatment for 6 months. Primary outcomes: the rate and duration of psychiatric readmissions. Results: We included 98 patients with BD. In ITT analyses, there was no statistically significant difference in rates (hazard rate: 1.05, 95% CI: 0.54; 1.91, p = 0.88) or duration of readmission between the two groups (B: 3.67, 95% CI: −4.77; 12.11, p = 0.39). There was no difference in scores on the Hamilton Depression Rating Scale (B = −0.11, 95% CI: −2.50; 2.29, p = 0.93). The intervention group had higher scores on the Young Mania Rating Scale (B: 1.89, 95% CI: 0.0078; 3.78, p = 0.050).The intervention group reported lower levels of perceived stress (B: -7.18, 95% CI: −13.50; −0.86, p = 0.026) and lower levels of rumination (B: −6.09, 95% CI: −11.19; −1.00, p = 0.019). Conclusions: Smartphone-based monitoring did not reduce rate and duration of readmissions. There was no difference in levels of depressive symptoms. The intervention group had higher levels of manic symptoms, but lower perceived stress and rumination compared with the control group.

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Section: Discussionmentioning

confidence: 99%

Reducing the rate of psychiatric re‐admissions in bipolar disorder using smartphones—The RADMIS trial

Faurholt‐Jepsen

Tønning

Fros³

et al. 2021

Acta Psychiatr Scand

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“…Rumination is a pattern of recursive and compulsive thinking focusing on one’s symptoms, causes, and consequences of distress ( Nolen-Hoeksema et al, 2008 , Papageorgiou and Siegle, 2003 ). Ruminators tend to have heightened risk of developing depressive episodes ( Nolen-Hoeksema, 2000 ), making rumination a common symptom of disorders characterized by affective dysregulation ( Kovács et al, 2020 , Nolen-Hoeksema, 2000 ). Particularly, although a profile of aberrant brain structure and functional network organization has been found in mood disorders (for a review, see Bi and He, 2014 , Gong and He, 2015 , Liu et al, 2021 ), the specific underlying neural mechanisms of rumination remains elusive to date.…”

Section: Introductionmentioning

confidence: 99%

“…To this end, we investigated the implication of structural connectivity and dynamic functional connectivity in rumination in individuals with MDD and healthy controls, and assessed how both types of connectivity are related to their rumination via a multimodal approach. Rumination is a common feature in disorders categorized by affective dysregulation ( Kovács et al, 2020 ), the strong association between rumination and depression in particular has thus rendered this MDD patient population an ideal sample ( Nolen-Hoeksema, 2000 , Nolen-Hoeksema et al, 2008 ). We hypothesized that white matter integrity captured in diffusion tensor imaging (DTI) data, and the global synchrony and global metastability captured in rs-fMRI data would be significantly different between the two groups.…”

Section: Introductionmentioning

confidence: 99%

Aberrant functional metastability and structural connectivity are associated with rumination in individuals with major depressive disorder

Zhang

Tam

Wong

et al. 2022

NeuroImage: Clinical

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Highlights Higher synchrony and lower metastability in adults with higher levels of rumination. Prefrontal white matter integrity deficits are also associated with rumination. Most prominent aberrations were found in the genu of the corpus callosum. Structural connectivity as the basis between dynamic connectivity and rumination. New outlook on altered structural integrity and metastability subserving rumination.

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“…One of the key features of BD patients is their tendency to engage in maladaptive emotion regulation strategies such as depressive rumination, which they have in common with patients suffering from major depressive disorder (MDD) (6)(7)(8). Depressive rumination can be described as the process of thinking perseveratively about one's negative feelings and problems and their possible causes and consequences and is associated with depressive symptoms (9), also in BD (10,11).…”

Section: Introductionmentioning

confidence: 99%

“…By becoming increasingly aware of automatic maladaptive cognitive processes and learning to decenter and disengage from them, patients prevent themselves to enter a vicious cycle of ruminative thinking that could otherwise aggravate symptoms of depression (18). As MDD and BD patients have many characteristics in common, such as the tendency to engage in ruminative thinking (6,8), it has been hypothesized that MBCT may also be an effective treatment for BD (19). Indeed, various systematic reviews concluded that MBCT seems promising as a treatment for BD, and that rumination may be an important therapeutic target (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Mindfulness-Based Cognitive Therapy On Rumination and Intrusive Thoughts in Patients With Bipolar Disorder: Secondary Analyses From a Randomized Controlled Trial

Lubbers

Geurts

Hanssen

et al. 2021

Preprint

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Background: Preliminary evidence suggests that Mindfulness-Based Cognitive Therapy (MBCT) is a promising treatment for bipolar disorder (BD). One of the proposed working mechanisms of MBCT in attenuating depressive symptoms is through the reduction of depressive rumination. In BD the effect of MBCT on rumination is less well studied. The primary aim of this study was to investigate the effect of MBCT on self-reported trait depressive rumination and an experimental state measure of negative intrusive thoughts. On an exploratory note, we investigated the effect of MBCT on positive rumination and positive intrusive thoughts.Methods: The study population consisted of a subsample of bipolar type I or II patients participating in a multicenter randomized controlled trial comparing MBCT + treatment as usual (TAU) (N = 25) to TAU alone (N = 24). Trait depressive rumination (RRS brooding subscale) and negative intrusive thoughts (breathing focus task (BFT)) were assessed at baseline and post-treatment. During the BFT, participants were asked to report negative, positive and neutral intrusive thoughts while focusing on their breathing. Results: Compared to TAU alone, MBCT + TAU resulted in a significant pre- to post-treatment reduction of trait depressive rumination (R2 = 0.16, F(1, 28) = 5.30, p = .029; medium effect size (f2 = 0.19)) and negative intrusive thoughts on the BFT (R2 = .15, F(1, 28) = 4.88, p = .036; medium effect size (f2 = 0.17)). MBCT did not significantly change positive rumination or positive intrusive thoughts on the BFT.Conclusions: MBCT might be a helpful additional intervention to reduce depressive rumination in BD which might reduce risk of depressive relapse or recurrence. Future research is required to replicate our findings and to explore whether this reduction in rumination following MBCT indeed mediates a reduction in depressive symptoms and leads to relapse prevention in BD.

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Rumination in major depressive and bipolar disorder – a meta-analysis

Cited by 54 publications

References 66 publications

Reducing the rate of psychiatric re‐admissions in bipolar disorder using smartphones—The RADMIS trial

Reducing the rate of psychiatric re‐admissions in bipolar disorder using smartphones—The RADMIS trial

Aberrant functional metastability and structural connectivity are associated with rumination in individuals with major depressive disorder

The Effect of Mindfulness-Based Cognitive Therapy On Rumination and Intrusive Thoughts in Patients With Bipolar Disorder: Secondary Analyses From a Randomized Controlled Trial

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