Residual subjective depressive symptoms and resilience in patients with bipolar disorder

Abstract

Background: Residual symptoms experienced by patients with bipolar disorder (BD) is a risk factor for illness relapse/recurrence, and these symptoms are associated with a lower quality of life. Resilience allows patients to cope with stress effectively and acts as a protective factor against relapse. Therefore, this study aimed to determine the relationship between resilience and residual subjective depressive symptoms in euthymic patients with BD. Methods: A total of 49 euthymic patients with BD completed the Quick Inventory of Depressive SymptomatologySelf Report (QIDS-SR) and the Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis was performed to investigate the association between QIDS-SR and CD-RISC scores. Results: The mean Clinical Global Impression for BD (CGI-BP) and QIDS-SR scores were 1.3 +/- 0.5 and 8.0 +/- 5.8, respectively. Although clinically stable according to objective assessment using the CGI-BP, patients with BD experienced residual subjective depressive symptoms. After adjusting for demographic and clinical characteristics, CD-RISC scores could predict QIDS-SR scores significantly in a hierarchical multiple regression. The association between CD-RISC and QIDS-SR scores did not differ according to CGI-BP scores. Limitations: The clinical status was objectively evaluated using the CGI-BP alone. This was a cross-sectional study with a relatively small number of patients with BD, complicating the determination of the exact causal relationship between residual depressive symptoms and resilience. Conclusion: Higher levels of resilience appears to be associated with lower subjective residual depressive symptoms in euthymic patients with BD. Resilience could play a protective role against the residual subjective depressive symptoms experienced by clinically stable patients with BD.