Associations of dysfunctional attitudes, ruminations and metacognitive beliefs about rumination with pharmacological treatment response in patients with first episode of major depression.

INTRODUCTION: The aim of this study is to investigate whether treatment with selective serotonin reuptake inhibitors (SSRI) has an effect on the ruminative response, ruminative beliefs and dysfunctional attitudes (DA), and to evaluate the effects of pre-treatment dysfunctional attitudes and rumination levels on treatment response in individuals diagnosed with the first episode of major depression (MD). METHODS: 110 patients with MD participated in this study. Participants were evaluated with the Hamilton Depression Rating Scale (HDRS), the Clinical Global Impression Scale (CGI), the Short Version of Ruminative Response Scale (RRS), the Positive Beliefs about Rumination Scale (PBRS), the Negative Beliefs about Rumination Scale (NBRS), and the Dysfunctional Attitude Scale form A (DAS-A) before receiving SSRI treatment and 2 months after the onset of treatment. RESULTS: After two months of SSRI treatment, patients were divided into two groups, remission and non-remission groups. The decrease in RRS subscales and total scores, NBRS uncontrollability and danger of ruminations score, PBRS total score and DAS-A autonomous attitude scores were significantly higher in the remission group. RRS and DAS-A scores were found to be predictors of remission. CONCLUSIONS: DA and ruminations may be associated with poor response to SSRI treatment in depression. KEY POINTSAfter treatment with selective serotonin reuptake inhibitors, ruminations, dysfunctional attitudes, and positive and negative metacognitions on ruminations significantly decreased in patients with a first episode of major depression.The decrease in ruminations, autonomous attitudes, the metacognitions on the uncontrollability and danger of ruminations, and positive metacognitions on ruminations was higher in remission group compared to the non-remission group.Ruminations and dysfunctional attitudes significantly predicted remission in first episode of major depression.

Resilience and insight in euthymic patients with bipolar disorder.

BACKGROUND: The relationship between resilience and insight may be of potential importance for coping with stress in bipolar disorder (BD). The aim of this study was to investigate if there was a relation between insight and resilience in euthymic patients with BD and also to analyze the associations between resilience, impulsivity, aggression, alcohol use and affective temperament. METHODS: 142 patients with BD type I in remission period were involved. Resilience Scale for Adults-Turkish version, Schedule for Assessment of Insight, Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire, Barratt Impulsiveness Scale, Buss-Perry Aggression Questionnaire, Michigan Alcoholism Screening Test were used. RESULTS: Total insight scores were negatively correlated with the scores of perception of future. As distinct from other subscales of resilience, family cohesion had independent significant associations with insight in relabelling of psychotic experiences and attention impulsivity. There was no relationship between total insight and total resilience scores. Resilience scores were negatively correlated with number of depressive episodes and number of suicide attempts. Degree of aggression, degree of impulsivity, scores of depressive and hyperthymic temperament significantly predicted resilience. LIMITATIONS: Recruitment of patients from a tertiary centre limits the generalizability of the findings. CONCLUSIONS: Better insight was related to negative perception of the future and did not have significant associations with total resilience. Number of depressive episodes, number of past suicide attempts correlated with resilience, emphasizing the importance of interventions to increase resilience in BD.