Evaluating psychological distress associated with life events under the traumatic experience threshold in patients with major depressive and bipolar disorder

Abstract

Patients with bipolar disorder (BD) and major depressive disorder (MDD) experience psychological distress associated with daily events that do not meet the threshold for traumatic experiences, referred to as event-related psychological distress (ERPD). Recently, we developed an assessment tool for ERPD, the ERPD-24. This tool considers four factors of ERPD: feelings of revenge, rumination, self-denial, and mental paralysis. We conducted a cross-sectional study between March 2021 and October 2022 to identify the differences and clinical features of ERPD among patients with MDD and BD and healthy subjects who did not experience traumatic events. Specifically, we assessed ERPD using the ERPD-24 and anxiety-related symptoms with the State-Trait Anxiety Inventory, Liebowitz Social Anxiety Scale, and anxious-depressive attack. We used a one-way analysis of variance test to compare differences among the groups, followed by a post hoc test. Non-remitted MDD patients and BD patients regardless of remission/non-remission presented more severe ERPD than healthy subjects. This study also demonstrated the relationships between all anxiety-related symptoms including social phobia and anxious-depressive attack and ERPD in both BD and MDD patients and in healthy subjects. In conclusion, patients with non-remitted MDD and with BD regardless of remission/non-remission experience severe ERPD related to anxiety-related symptoms.