Exploring factors associated with personal recovery in bipolar disorder

Abstract

Background Personal recovery is increasingly recognized as important outcome for people with bipolar disorder (BD), but research addressing associated factors of personal recovery in this group remains scarce. This study aimed to explore the association of sociodemographic variables, social participation, psychopathology, and positive emotion regulation with personal recovery in BD. Methods Baseline data from a randomized controlled trial and survey data were combined ( N = 209) and split into a training ( n = 149) and test sample ( n = 60). Block‐wise regression analyses and model training were used to determine the most relevant predictors. The final parsimonious model was cross‐validated in the test sample. Results In the final parsimonious model, satisfaction with social roles (β = .442, p < .001), anxiety symptoms (β = −.328, p < .001), manic symptoms (β = .276, p < .001), and emotion‐focused positive rumination (β = .258, p < .001) were independently associated with personal recovery. The model explained 57.3% variance in personal recovery (adjusted R 2 = .561) and performed well in predicting personal recovery in the independent test sample (adjusted R 2 = .491). Conclusions Our findings suggest that especially social participation, anxiety and positive rumination might be relevant treatment targets when aiming to improve personal recovery. Practitioner points Personal recovery is considered an increasingly important outcome for people with chronic mental health conditions, including bipolar disorder. We found that anxiety and manic symptoms as well as positive rumination and social participation were independently associated with personal recovery in bipolar disorder. Therefore, these outcomes might be relevant treatment targets when aiming to improve personal recovery in bipolar disorder. Possible interventions to improve these outcomes are discussed, including supported employment and vocational rehabilitation for social participation and exercising with savoring strategies to increase positive rumination.

Exploring the Personal Recovery Construct in Bipolar Disorders: Definition, Usage and Measurement. A Systematic Review

“…Some of the salient features of PR found here are similar to those described in other SMIs [for a review see (7)]: needing to find meaning in life and a fixed point in one's life despite fluctuations (14), taking responsibility for one's health and finding ways to self-manage one's disorders, making "the choice to get better" (12,13), being employed and having a meaningful role (14,20,29,39). In addition to other SMIs, but counterintuitively concerning mood disorders, PR does not seem to correlate very closely with the symptomatology itself, especially manic states (21,22).…”

“…Indeed, our findings provide additional knowledge on more specific elements of PR in BD: first, a new relationship with fluctuating mood states, which includes, on the one hand, an acceptance of this reality and, on the other hand, a decrease in hypervigilance and active struggle against these fluctuations, which may even include risk taking (12,14,22,29,39). This notion of acceptance had been found by Jagfeld's team in a review of qualitative studies on PR in BD (6).…”

“…Low selfstigma, positive beliefs about BD, and good acceptance of mood swings were also associated with PR (22). Additionally, emotionfocused positive ruminations, described as the tendency to respond to positive emotions with recurrent thoughts about positive experiences, were positively correlated with PR (29). Additionally, the level of self-efficacy and self-management skills were related to PR (22).…”

“…Higher negative self-dispositional appraisals were associated with lower PR (39). Dampening, which is described as a cognitive strategy of suppression of positive moods to reduce the intensity of positive affect (40), was moderately associated with poor PR (29).…”

A Web-Based Positive Psychology App for Patients With Bipolar Disorder: Development Study

“…Several interventions have been developed based on the CHIME framework, focusing on increasing hope, strengths, connectedness, and empowerment [21,22]. A potential treatment approach to improve personal recovery and address the unmet needs of patients with BD is positive psychology (PP) [14,[23][24][25].…”