Research Article
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The relationship of mindful attention awareness and episode frequency in remitted bipolar disorder type I cases

Year 2021, Volume: 46 Issue: 2, 714 - 723, 30.06.2021
https://doi.org/10.17826/cumj.904859

Abstract

Purpose: The aim of this study was to investigate the relationship between mindful attention awareness (MAA) levels in euthymic bipolar disorder (BD) type I patients with the frequency of attacks, treatment compliance and insight levels.
Materials and Methods: Ninety-seven euthymic BD type I were included in the study. Sociodemography Data Form, Mindful Attention Awareness Scale (MAAS), Morisky Medication Adherence Scale (MMAS), Insight Assessment Scale (IAS) were applied to the patients who gave consent for the study.
Results: Patients with high and moderate treatment compliance were found to have higher levels of mindfulness than those with a low level. There was no statistically significant relationship between mindfulness levels and insight and frequency of episodes. The regression analyses revealed that treatment compliance was associated with the frequency of manic/hypomanic episodes in the last two years.
Conclusion: It has been found that BF levels present in the euthymic period have no effect on the frequency of episodes in BD patients. It has been determined that treatment compliance levels are high in BD patients with high MAA levels and that MAA has an increasing effect on treatment compliance. MAA increases treatment compliance, and the frequency of manic / hypomanic attacks decreases in patients with high treatment compliance.

References

  • Johnson SL. Life events in bipolar disorder: Towards more specific models. Clin Psychol Rev. 2005;25:1008-27.
  • Trede K, Salvatore P, Baethge C, Gerhard A, Maggini C, Baldessarini RJ. Manic-depressive illness: Evolution in Kraepelin’s textbook, 1883–1926. Harv Rev Psychiatry. 2005;13(3):155-78.
  • Judd LL, Schettler PJ, Akiskal HS, Coryell W, Leon AC, Maser JD et al. Residual symptom recovery from major affective episodes in bipolar disorder and rapid episode relapse/recurrence. Arch Gen Psychiatry. 2008;65:386-94.
  • Deckersbach T, Hölzel BK, Eisner LR, Stange JP, Peckham AD, Dougherty DD et al. Mindfulness-based cognitive therapy for nonremitted patients with bipolar disorder. CNS Neurosci Ther. 2012;18:133-41.
  • Ives-Deliperi VL, Howells F, Stein DJ, Meintjes EM, Horn N. The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: A controlled functional MRI investigation. J Affect Disord. 2013;150:1152-7.
  • Kenny MA, Williams JMG. Treatment-resistant depressed patients show a good response to mindfulness based cognitive therapy. Behav Res Ther. 2007;45:617-25.
  • Miklowitz DJ, Alatiq Y, Goodwin GM, Geddes JR, Fennel MJV, Dimidjian S et al. A pilot study of mindfulness-based cognitive therapy for bipolar disorder. International Journal of Cognitive Therapy. 2009;2(4):373-82.
  • Perich T, Manicavasagar V, Mitchell PB, Ball JR. The association between meditation practice and treatment outcome in mindfulness-based cognitive therapy for bipolar disorder. Behav Res Ther. 2013;51:338-43.
  • National Collaborating Centre for Mental Health. Depression: The treatment and management of depression in adults, United Kingdom, British Psychological Society, 2010.
  • Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2013;84:822-48.
  • Weinstein N, Brown KW, Ryan RM. A multi-method examination of the effects of mindfulness on stres attribution, coping, and emotional well-being. J Res Pers. 2009;43:374-85.
  • Kumar S, Feldman G, Hayes A. Changes in mindfulness and emotion regulation in an exposure-based cognitive therapy for depression. Cogn Ther Res. 2008;32:734-44.
  • Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consul Clin Psychol. 2010;78:169-83.
  • Holmes EM, Craske MG, Graybiel AM. A call for mental health science. Nature. 2014;511:287-9.
  • Chadwick P, Kaur H, Swelam M, Ross S, Ellet L. Experience of mindfulness in people with bipolar disorder: A qualitative study. Psychother Res. 2011;21:277-85.
  • Williams JMG, Alatiq Y, Crane C, Barnhofer T, Fennell MJV, Duggan DS et al. Mindfulness-based cognitive therapy (MBCT) in bipolar disorder: Preliminary evaluation of immediate effects on between episode functioning. J Affect Disord. 2008;107:275-9.
  • Van Dijk S, Jeffrey J, Katz MR. A randomized controlled pilot study of dialectical behavior therapy skills in psychoeducational group from individuals with bipolar disorder. J Affect Disord. 2013;145:386-93.
  • Perich T, Manicavasagar V, Mitchell PB, Ball JR, Hadzi-Pavlovic D. A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder. Acta Psychiatr Scand. 2013;127:333-43.
  • Weber B, Jermann F, Gex-Fabry M, Nallet A, Bondolfi G, Aubry J-M. Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial. Eur Psychiatry. 2010;25:334-7.
  • Howells FM, Rauch HGL, Ives-Deliperi VL, Horn NR, Stein DJ. Mindfulness based cognitive therapy may improve emotional processing in bipolar disorder: A pilot ERP and HRV study. Metab Brain Dis. 2014;29:367-75.
  • Trauer T, Sacks T. The relationship between insight and medication adherence in severely mentally ill clients treated in the community. Acta Psychiatr Scand. 2000;102:211-6.
  • Ateş MA, Algül A. Bipolar bozukluklarda tedavi uyumsuzluğu. Türkiye Klinikleri J Int Med Sci. 2006;2(29):60-4.
  • Sajatovic M, Levin J, Fuentes-Casiano E, Cassidy KA, Tatsuoka C, Jenkins JH. Illness experience and reasons for nonadherence among individuals with bipolar disorder who are poorly adherent with medication. Compr Psychiatry. 2011;52:280-7.
  • Christensen MV, Kessing LV. Clinical use of coping in affective disorder, a critical review of the literature. Clin Pract Epidemiol Ment Health. 2005; 1-20.
  • Patel NC, Patrick DM, Youngstrom EA, Strakowski SM, Delbello MP. Response and remission in adolescent mania: Signal detection analyses of the young mania rating scale. J Am Acad Child Adolesc Psychiatry. 2007;46:628–35.
  • Israel JA. Remission in depression: Definition and initial treatment approaches. J Psychopharmacol. 2006;20:5–10.
  • Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62.
  • Akdemir A, Örsel SD, Dağ İ, Türkçapar MH, İşcan N, Özbay H. Hamilton Depresyon Derecelendirme Ölçeği'nin geçerliği, güvenilirliği ve klinikte kullanımı. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1996;4(4):251-9.
  • Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-35.
  • Karadağ F, Oral ET, Yalçın FA, Erten E. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Türk Psikiyatri Derg. 2001;13:107-14.
  • Özyeşil Z, Arslan C, Kesici Ş, Deniz ME. Bilinçli Farkındalık Ölçeği’ni Türkçeye Uyarlama Çalışması. Eğitim ve Bilim. 2011;36(160):224-35.
  • David AS. Insight and psychosis. Br J Psychiatry. 1960;156:798-808.
  • Aslan S, Karakılıç H, Işıklı S, Coşar B, Işık E. İçgörünün üç bileşenini değerlendirme ölçeği: güvenilirlik ve geçerlik çalışması. Türkiye’de Psikiyatri Dergisi. 2001;3(2):17-24.
  • Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67-74.
  • Bahar G, Savaş HA, Ünal A, Savaş E, Kaya H, Bahar A. Morisky Tedaviye Uyum Ölçeğinin iki uçlu duygudurum bozukluğu için geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Derg. 2014;15:141-9.
  • Bates JA, Whitehead R, Bolge SC, Kim E. Correlates of medication adherence among bipolar disorder: Results of the bipolar evaluation of satisfaction and tolerability (BEST) study: A nationwide cros-sectional survey. Prim Care Companion J Clin Psychiatry. 2010;12(5):1-10.
  • Kessing LV, Hansen HV, Bech P. Attitudes and beliefs among patients treated with mood stabilizers. Clinical Practice and Epidemiology in Mental Health. 2006;2:8.
  • Baldessarini RJ, Perry R, Pike J. Factors associated with treatment nonadherence among US bipolar disorder patients. Hum Psychopharmacol Clin Exp. 2008;23:95-105.
  • Savaş HA, Ünal A, Vırıt O. Treatment Adherence in Bipolar Disorder. Journal of Mood Disorders. 2011;1:95-102.
  • Greenhouse WJ, Meyer B, Johnson SL. Coping and medication adherence in bipolar disorder. J Affect Disord. 2000;59:237-41.
  • Kuyken W, Watkins E, Holden E, White K, Taylor RS, Byford S et al. How does mindfulness-based cognitive therapy work? Behav Res Ther. 2010;48:1105-12.
  • Lam D, Wong G, Sham P. Prodromes, coping strategies and course of illness in bipolar affective disorder-a naturalistic study. Psychol Med. 2001;31:1397-402.

Remisyonda olan bipolar bozukluk tip I olgularında bilinçli farkındalık ve atak sıklığı ilişkisi

Year 2021, Volume: 46 Issue: 2, 714 - 723, 30.06.2021
https://doi.org/10.17826/cumj.904859

Abstract

Amaç: Bu çalışmada ötimik bipolar bozukluk (BB) tip I hastalarda var olan bilinçli farkındalık (BF) düzeylerinin atak sıklıkları, tedavi uyumları ve iç görü düzeyleri ile ilişkilerinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmaya düzenli kontrole gelen 97 ötimik BB tip 1 hasta alınmıştır. Katılımcılara Sosyodemografi Veri Formu, Bilinçli Farkındalık Ölçeği (BFÖ), Morisky İlaç Uyum Ölçeği (MUÖ), İç görü Değerlendirme Ölçeği (İDÖ) uygulanmıştır.
Bulgular: Tedavi uyumu yüksek ve orta düzeyde olan hastalarda, düşük düzeyde olanlara göre BF düzeyleri yüksek bulunmuştur. BF düzeyi ile iç görü düzeyi ve atak sıklıkları arasında istatistiksel olarak anlamlı ilişki bulunmamıştır. Regresyon analizlerinde ise hastalarda tedaviye uyum düzeylerinin son iki yıldaki manik/hipomanik atak sıklığı ile anlamlı ilişkisinin olduğu belirlenmiştir.
Sonuç: BB hastalarında ötimik dönemde var olan BF düzeylerinin atak sıklığı üzerinde etkisinin olmadığı bulunmuştur. BF düzeyleri yüksek olan BB hastalarında tedavi uyum düzeylerinin yüksek olduğu ve BF’nin tedaviye uyumu artırıcı bir etkisinin olduğu belirlenmiştir. BF tedavi uyumunu artırmakta, tedavi uyumu yüksek hastalarda ise manik/hipomanik atak sıklığı azalmaktadır..

References

  • Johnson SL. Life events in bipolar disorder: Towards more specific models. Clin Psychol Rev. 2005;25:1008-27.
  • Trede K, Salvatore P, Baethge C, Gerhard A, Maggini C, Baldessarini RJ. Manic-depressive illness: Evolution in Kraepelin’s textbook, 1883–1926. Harv Rev Psychiatry. 2005;13(3):155-78.
  • Judd LL, Schettler PJ, Akiskal HS, Coryell W, Leon AC, Maser JD et al. Residual symptom recovery from major affective episodes in bipolar disorder and rapid episode relapse/recurrence. Arch Gen Psychiatry. 2008;65:386-94.
  • Deckersbach T, Hölzel BK, Eisner LR, Stange JP, Peckham AD, Dougherty DD et al. Mindfulness-based cognitive therapy for nonremitted patients with bipolar disorder. CNS Neurosci Ther. 2012;18:133-41.
  • Ives-Deliperi VL, Howells F, Stein DJ, Meintjes EM, Horn N. The effects of mindfulness-based cognitive therapy in patients with bipolar disorder: A controlled functional MRI investigation. J Affect Disord. 2013;150:1152-7.
  • Kenny MA, Williams JMG. Treatment-resistant depressed patients show a good response to mindfulness based cognitive therapy. Behav Res Ther. 2007;45:617-25.
  • Miklowitz DJ, Alatiq Y, Goodwin GM, Geddes JR, Fennel MJV, Dimidjian S et al. A pilot study of mindfulness-based cognitive therapy for bipolar disorder. International Journal of Cognitive Therapy. 2009;2(4):373-82.
  • Perich T, Manicavasagar V, Mitchell PB, Ball JR. The association between meditation practice and treatment outcome in mindfulness-based cognitive therapy for bipolar disorder. Behav Res Ther. 2013;51:338-43.
  • National Collaborating Centre for Mental Health. Depression: The treatment and management of depression in adults, United Kingdom, British Psychological Society, 2010.
  • Brown KW, Ryan RM. The benefits of being present: Mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2013;84:822-48.
  • Weinstein N, Brown KW, Ryan RM. A multi-method examination of the effects of mindfulness on stres attribution, coping, and emotional well-being. J Res Pers. 2009;43:374-85.
  • Kumar S, Feldman G, Hayes A. Changes in mindfulness and emotion regulation in an exposure-based cognitive therapy for depression. Cogn Ther Res. 2008;32:734-44.
  • Hofmann SG, Sawyer AT, Witt AA, Oh D. The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. J Consul Clin Psychol. 2010;78:169-83.
  • Holmes EM, Craske MG, Graybiel AM. A call for mental health science. Nature. 2014;511:287-9.
  • Chadwick P, Kaur H, Swelam M, Ross S, Ellet L. Experience of mindfulness in people with bipolar disorder: A qualitative study. Psychother Res. 2011;21:277-85.
  • Williams JMG, Alatiq Y, Crane C, Barnhofer T, Fennell MJV, Duggan DS et al. Mindfulness-based cognitive therapy (MBCT) in bipolar disorder: Preliminary evaluation of immediate effects on between episode functioning. J Affect Disord. 2008;107:275-9.
  • Van Dijk S, Jeffrey J, Katz MR. A randomized controlled pilot study of dialectical behavior therapy skills in psychoeducational group from individuals with bipolar disorder. J Affect Disord. 2013;145:386-93.
  • Perich T, Manicavasagar V, Mitchell PB, Ball JR, Hadzi-Pavlovic D. A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder. Acta Psychiatr Scand. 2013;127:333-43.
  • Weber B, Jermann F, Gex-Fabry M, Nallet A, Bondolfi G, Aubry J-M. Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial. Eur Psychiatry. 2010;25:334-7.
  • Howells FM, Rauch HGL, Ives-Deliperi VL, Horn NR, Stein DJ. Mindfulness based cognitive therapy may improve emotional processing in bipolar disorder: A pilot ERP and HRV study. Metab Brain Dis. 2014;29:367-75.
  • Trauer T, Sacks T. The relationship between insight and medication adherence in severely mentally ill clients treated in the community. Acta Psychiatr Scand. 2000;102:211-6.
  • Ateş MA, Algül A. Bipolar bozukluklarda tedavi uyumsuzluğu. Türkiye Klinikleri J Int Med Sci. 2006;2(29):60-4.
  • Sajatovic M, Levin J, Fuentes-Casiano E, Cassidy KA, Tatsuoka C, Jenkins JH. Illness experience and reasons for nonadherence among individuals with bipolar disorder who are poorly adherent with medication. Compr Psychiatry. 2011;52:280-7.
  • Christensen MV, Kessing LV. Clinical use of coping in affective disorder, a critical review of the literature. Clin Pract Epidemiol Ment Health. 2005; 1-20.
  • Patel NC, Patrick DM, Youngstrom EA, Strakowski SM, Delbello MP. Response and remission in adolescent mania: Signal detection analyses of the young mania rating scale. J Am Acad Child Adolesc Psychiatry. 2007;46:628–35.
  • Israel JA. Remission in depression: Definition and initial treatment approaches. J Psychopharmacol. 2006;20:5–10.
  • Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry. 1960;23:56-62.
  • Akdemir A, Örsel SD, Dağ İ, Türkçapar MH, İşcan N, Özbay H. Hamilton Depresyon Derecelendirme Ölçeği'nin geçerliği, güvenilirliği ve klinikte kullanımı. Psikiyatri Psikoloji Psikofarmakoloji (3P) Dergisi. 1996;4(4):251-9.
  • Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-35.
  • Karadağ F, Oral ET, Yalçın FA, Erten E. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Türk Psikiyatri Derg. 2001;13:107-14.
  • Özyeşil Z, Arslan C, Kesici Ş, Deniz ME. Bilinçli Farkındalık Ölçeği’ni Türkçeye Uyarlama Çalışması. Eğitim ve Bilim. 2011;36(160):224-35.
  • David AS. Insight and psychosis. Br J Psychiatry. 1960;156:798-808.
  • Aslan S, Karakılıç H, Işıklı S, Coşar B, Işık E. İçgörünün üç bileşenini değerlendirme ölçeği: güvenilirlik ve geçerlik çalışması. Türkiye’de Psikiyatri Dergisi. 2001;3(2):17-24.
  • Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986;24:67-74.
  • Bahar G, Savaş HA, Ünal A, Savaş E, Kaya H, Bahar A. Morisky Tedaviye Uyum Ölçeğinin iki uçlu duygudurum bozukluğu için geçerlilik ve güvenilirlik çalışması. Anadolu Psikiyatri Derg. 2014;15:141-9.
  • Bates JA, Whitehead R, Bolge SC, Kim E. Correlates of medication adherence among bipolar disorder: Results of the bipolar evaluation of satisfaction and tolerability (BEST) study: A nationwide cros-sectional survey. Prim Care Companion J Clin Psychiatry. 2010;12(5):1-10.
  • Kessing LV, Hansen HV, Bech P. Attitudes and beliefs among patients treated with mood stabilizers. Clinical Practice and Epidemiology in Mental Health. 2006;2:8.
  • Baldessarini RJ, Perry R, Pike J. Factors associated with treatment nonadherence among US bipolar disorder patients. Hum Psychopharmacol Clin Exp. 2008;23:95-105.
  • Savaş HA, Ünal A, Vırıt O. Treatment Adherence in Bipolar Disorder. Journal of Mood Disorders. 2011;1:95-102.
  • Greenhouse WJ, Meyer B, Johnson SL. Coping and medication adherence in bipolar disorder. J Affect Disord. 2000;59:237-41.
  • Kuyken W, Watkins E, Holden E, White K, Taylor RS, Byford S et al. How does mindfulness-based cognitive therapy work? Behav Res Ther. 2010;48:1105-12.
  • Lam D, Wong G, Sham P. Prodromes, coping strategies and course of illness in bipolar affective disorder-a naturalistic study. Psychol Med. 2001;31:1397-402.
There are 42 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research
Authors

Soner Çakmak 0000-0003-4212-7096

Lut Tamam 0000-0002-9750-7531

Publication Date June 30, 2021
Acceptance Date April 24, 2021
Published in Issue Year 2021 Volume: 46 Issue: 2

Cite

MLA Çakmak, Soner and Lut Tamam. “Remisyonda Olan Bipolar Bozukluk Tip I olgularında bilinçli farkındalık Ve Atak sıklığı ilişkisi”. Cukurova Medical Journal, vol. 46, no. 2, 2021, pp. 714-23, doi:10.17826/cumj.904859.