Coping Styles of Outpatients With a Bipolar Disorder

doi:10.1016/j.apnu.2007.07.001

Archives of Psychiatric Nursing

Volume 22, Issue 5, October 2008, Pages 245-253

https://doi.org/10.1016/j.apnu.2007.07.001 Get rights and content

Patients with a bipolar disorder need to cope with the problems they encounter, the consequences of their disease, and unpleasant events to stay well. This study was undertaken to gain greater insight into the coping styles of outpatients with a bipolar disorder when confronted with problems and unpleasant events. The participants (N = 157) completed the Utrecht Coping List and a questionnaire addressing various demographic and clinical characteristics. The results showed outpatients with a bipolar disorder to have a less active reaction pattern and a more avoidant coping style compared with people from the general population.

Section snippets

Methods

The present study followed a quantitative cross-sectional research design; that is, data were collected at one moment in time.

Results

Of the 201 patients who initially showed interest in study participation, 158 actually participated (79%). Various reasons were provided for nonparticipation: fear of destabilization; depressed or (hypo)manic mood state at the time of the appointment; hospitalization; unwillingness to travel; nonmental illness at the time of the appointment; talked out of participation by relatives; and just not showing up for the appointment. One patient declined to participate further during the interview

Discussion

To our knowledge, this is the first study to quantitatively examine the coping styles of a population of outpatients with a bipolar disorder. The results should nevertheless be considered in light of some possible methodological limitations. Although the use of the psychometrically sound UCL to measure coping styles and the sufficiently large sample size make this study thorough, it should be mentioned that all of the data were self-reported data, which increase the risk of social desirability

Conclusions

In the present study, the coping styles used by outpatients with a bipolar disorder in The Netherlands were examined. The outpatients were generally found to report using a less active, more passive, and more avoidant coping style when confronted with problems or unpleasant events compared with people in the general population. In addition, the coping styles of the outpatients also differed somewhat from those of the normal population depending on sex. Male outpatients were better able to

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Cited by (17)

Coping and personality in older patients with bipolar disorder
2015, Journal of Affective Disorders
Citation Excerpt :
Compared to patients with unipolar depression, adult BD patients have more active coping skills (Coulston et al., 2013). However, compared with the general population, adult BD patients (age range 23–65) show a more passive coping style (Goossens et al., 2008). Kramer et al. (2009) also found a lower level of active coping in BD patients compared to healthy controls.
Little is known about coping styles and personality traits in older bipolar patients. Adult bipolar patients show a passive coping style and higher neuroticism scores compared to the general population. Our aim is to investigate personality traits and coping in older bipolar patients and the relationship between coping and personality.
75 Older patients (age>60) with bipolar I or II disorder in a euthymic mood completed the Utrecht Coping List and the NEO Personality Inventory FFI and were compared to normative data.
Older bipolar patients show more passive coping styles compared to healthy elderly. Their personality traits are predominated by openness, in contrast conscientiousness and altruism are relatively sparse. Neuroticism was related to passive coping styles, whereas conscientiousness was related to an active coping style.
Older bipolar patients have more passive coping styles. Their personality is characterized by openness and relatively low conscientiousness and altruism. Our sample represents a survival cohort; this may explain the differences in personality traits between older patients in this study and in adult bipolar patients in other studies. The association between coping styles and personality traits is comparable to reports of younger adult patients with bipolar disorder. Longitudinal studies are warranted to explore if coping and personality change with ageing in bipolar patients and to determine which coping style is most effective in preventing mood episodes.
Relationships among stress coping styles and pregnancy complications among women exposed to hurricane katrina
2015, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
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Given the limited research in these areas, it is hard to compare findings to previous literature. A few works have commented on the negative aspect of denial coping style, but most of these studies looked at its adverse consequence on mental health or its impact on recovery from health challenges (Gonzalez‐Freire, Vazquez‐Rodriguez, Marcos‐Velazquez, & de la Cuesta, 2010; Goossens, Knoppert‐van der Klein, & van Achterberg, 2008; Parikh et al., 2007). In a study among people recently diagnosed with diabetes, denial of the disease during the first 5 years was associated with poor glycemic control (Garay‐Sevilla, Malacara, Gutiérrez‐Roa, & González, 1999).
To examine the relationship between maternal stress exposure, stress coping styles, and pregnancy complications.
Quantitative, cross‐sectional, and prospective study.
Tulane‐Lakeside Hospital, New Orleans, LA and Women's Hospital, Baton Rouge, LA.
The study included 146 women (122 from New Orleans and 24 from Baton Rouge), who were pregnant during or immediately after Hurricane Katrina.
Participants were interviewed regarding their hurricane experiences and perceived stress, and coping styles were assessed using the Brief COPE. Medical charts were also reviewed to obtain information about pregnancy outcomes. Logistic regression was performed to determine possible associations.
Hurricane exposure was significantly associated with induction of labor (adjusted odds ratio [aOR] = 1.39; 95% confidence interval [CI] [1.03, 1.86], P = .03) and current perceived stress (aOR = 1.50, CI [1.34, 1.99], P < .01). Stress perception significantly predisposed to pregnancy‐induced hypertension (aOR = 1.16, CI [1.05, 1.30], P < .01) and gestational diabetes (aOR = 1.13, CI [1.02, 1.25], P = .03). Use of planning, acceptance, humor, instrumental support, and venting coping styles were associated with a significantly reduced occurrence of pregnancy complications (P < .05). Higher rates for gestational diabetes was found among women using the denial coping style (aOR = 2.25, CI [1.14, 4.45], P = .02).
Exposure to disaster‐related stress may complicate pregnancy, whereas some coping styles may mitigate its effects. Further research should explore how coping styles may mitigate or exacerbate the effect of major stressors and how positive coping styles can be encouraged or augmented.
Is coping well a matter of personality? A study of euthymic unipolar and bipolar patients
2013, Journal of Affective Disorders
Citation Excerpt :
By training patients to continuously re-appraise negative thoughts and underlying core beliefs about the self through cognitive restructuring, patients are able to modify their reactions to negative life events and hence prevent depression (Hollon et al., 2006). The results from this study, in agreement with previous research, suggest that adaptive coping styles already appear to be operational during the euthymic phase of BD (Goossens et al., 2008; Mitchell and Romans, 2003; Parikh et al., 2007). Clinical practice recommendations for BD (Malhi et al., 2009a) therefore advocate a range of other maintenance treatment strategies, including psychoeducation and mood monitoring for early warning signs of relapse during euthymia.
Euthymic bipolar disorder (BD) patients often demonstrate better clinical outcomes than remitted patients with unipolar illness (UP). Reasons for this are uncertain, however, personality and coping styles are each likely to play a key role. This study examined differences between euthymic BD and UP patients with respect to the inter-relationship between personality, coping style, and clinical outcomes.
A total of 96 UP and 77 BD euthymic patients were recruited through the CADE Clinic, Royal North Shore Hospital in Sydney, and assessed by a team comprising Psychiatrists and Psychologists. They underwent a structured clinical diagnostic interview, and completed self-report measures of depression, anxiety, stress, personality, coping, social adjustment, self-esteem, dysfunctional attitudes, and fear of negative evaluation.
Compared to UP, BD patients reported significantly higher scores on levels of extraversion, adaptive coping, self-esteem, and lower scores on trait anxiety and fear of negative evaluation. Extraversion correlated positively with self-esteem, adaptive coping styles, and negatively with trait anxiety and fear of negative evaluation. Trait anxiety and fear of negative evaluation correlated positively with eachother, and both correlated negatively with self-esteem and adaptive coping styles. Finally, self-esteem correlated positively with adaptive coping styles.
The results cannot be generalised to depressive states of BD and UP, as differences in the course of illness and types of depression are likely to impact on coping and clinical outcomes, particularly for BD.
During remission, functioning is perhaps better ‘preserved’ in BD than in UP, possibly because of the protective role of extraversion which drives healthier coping styles.
Recognising prodromes of manic or depressive recurrence in outpatients with bipolar disorder: A cross-sectional study
2010, International Journal of Nursing Studies
There is some evidence that teaching patients to recognise prodromes of manic and depressive episodes improved time to recurrence and hospitalization, social function, and performance in employment. Little information is available about which prodromal symptom patients with bipolar disorder recognise as being the very first symptom of recurrence.
The aims of this study were to describe the very first symptoms in manic or depressive recurrence reported by patients with bipolar disorder and to explore associations between the ability to recognise these prodromal symptoms and the clinical characteristics of these patients.
A cross-sectional, descriptive design.
Five psychiatric outpatient clinics in the Netherlands.
111 outpatients diagnosed with bipolar disorder, currently not in an episode.
Data were obtained through a face-to-face interview with open ended questions and a questionnaire for demographic and clinical characteristics. Reported prodromes were categorised in an instrument inductively constructed and based on literature review and expert opinion. Associations were calculated with chi squares.
The first recognised symptom of recurrence in mania was change in energy level (21%), sleep (17%), and social functioning (16%). In depression it was change in thought (15%), mood stability (12%), energy level (12%), social functioning (11%), and sleep (10%). Twenty-eight percent of the patients were not able to recognise prodromes of recurrence in mania. Also 28% was not able to recognise prodromes of depression, and 12% was not able to recognise either of them. A significant association (p = 0.033) was found between the ability to recognise prodromes of depression and the lifetime number of depressive episodes.
The majority of euthymic patients with bipolar disorder are able to recognise prodromes of recurrence. These warning signs often emerge early in the process of recurrence. Our results suggest that patients learn to recognise prodromes of recurrence rather by experience than from therapeutic interventions. Talking to patients and their relatives closely after recovered from an episode to construct the early phase of recurrence can be important to improve recognition and prevent future episodes of mania or depression.
Associations of Attachment and Coping Styles with Social Functioning in Patients with Bipolar Disorder I
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Differences in coping strategies in adult patients with bipolar disorder and their first-degree relatives in comparison to healthy controls
2018, Trends in Psychiatry and Psychotherapy

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Coping Styles of Outpatients With a Bipolar Disorder

Section snippets

Methods

Results

Discussion

Conclusions

Patient Education and Counseling

European Psychiatry: The Journal of the Association of European Psychiatrists

Home Care

Archives of Psychiatric Nursing

Journal of Affective Disorders

Clinical Psychology Review

European Neuropsychopharmacology

Psychiatric Clinics of North America