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Self-esteem, social adjustment and suicidality in affective disorders

Published online by Cambridge University Press:  16 April 2020

E.G. Daskalopoulou ,
D.G. Dikeos ,
G.N. Papadimitriou ,
D. Souery ,
S. Blairy ,
I. Massat ,
J. Mendlewicz  and
C.N. Stefanis
E.G. Daskalopoulou
Affiliation:
University Mental Health Research Institute, Athens University Medical School, Eginition Hospital, 72-74, Vas Sofias Avenue, 11528Athens, Greece Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, Greece
D.G. Dikeos
Affiliation:
University Mental Health Research Institute, Athens University Medical School, Eginition Hospital, 72-74, Vas Sofias Avenue, 11528Athens, Greece Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, Greece
G.N. Papadimitriou*
Affiliation:
University Mental Health Research Institute, Athens University Medical School, Eginition Hospital, 72-74, Vas Sofias Avenue, 11528Athens, Greece Department of Psychiatry, Athens University Medical School, Eginition Hospital, 11528 Athens, Greece
D. Souery
Affiliation:
Department of Psychiatry, Free University of Brussels, Erasme Hospital, 1070Brussels, Belgium
S. Blairy
Affiliation:
Department of Psychiatry, Free University of Brussels, Erasme Hospital, 1070Brussels, Belgium
I. Massat
Affiliation:
Department of Psychiatry, Free University of Brussels, Erasme Hospital, 1070Brussels, Belgium
J. Mendlewicz
Affiliation:
Department of Psychiatry, Free University of Brussels, Erasme Hospital, 1070Brussels, Belgium
C.N. Stefanis
Affiliation:
University Mental Health Research Institute, Athens University Medical School, Eginition Hospital, 72-74, Vas Sofias Avenue, 11528Athens, Greece
*
*Corresponding author. E-mail address:[email protected] (D.G. Dikeos).
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Summary

Self-esteem (SE) and social adjustment (SA) are often impaired during the course of affective disorders; this impairment is associated with suicidal behaviour. The aim of the present study was to investigate SE and SA in unipolar or bipolar patients in relation to demographic and clinical characteristics, especially the presence of suicidality (ideation and/or attempt). Forty-four patients, 28 bipolar and 16 unipolar, in remission for at least 3 months, and 50 healthy individuals were examined through a structured clinical interview. SE and SA were assessed by the Rosenberg self-esteem scale and the social adjustment scale, respectively. The results have shown that bipolar patients did not differ from controls in terms of SE, while unipolar patients had lower SE than bipolars and controls. No significant differences in the mean SA scores were found between the three groups. Suicidality during depression was associated only in bipolar patients with lower SE at remission; similar but not as pronounced was the association of suicidality with SA. It is concluded that low SE lasting into remission seems to be related to the expression of suicidality during depressive episodes of bipolar patients, while no similar pattern is evident in unipolar patients.

Keywords

Self-esteemSocial adjustmentSuicidalityAffective disorder
Type
Original article
Information
European Psychiatry , Volume 17 , Issue 5 , September 2002 , pp. 265 - 271
Copyright
Copyright © European Psychiatric Association 2002

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References

Judd, LL. Mood disorders in the general population represent an important and worldwide public health problem. Int Clin Psychopharmacol 1995;10(Suppl 4):5–10.CrossRefGoogle ScholarPubMed
Mendlewicz, J. Population and family studies in depression and mania. Br J Psychiatry 1988;3:16–25.CrossRefGoogle Scholar
Tsuang, MTFaraone, SV. The genetics of mood disorders. Baltimore: Johns Hopkins University Press; 1990.Google Scholar
Stefanis, CNDikeos, DGPapadimitriou, GN. Clinical strategies in genetic research. In: Mendlewicz, JPapadimitriou, GN editors. Genetics of mental disorders Part I: theoretical aspects. Bailliere’s Clinical Psychiatry, International Practice and Research. London: Bailliere Tindall; 1995. p. 1–18.Google Scholar
Souery, DPapadimitriou, GNMendlewicz, J. New molecular genetic studies in affective disorders. In: Papadimitriou, GNMendlewicz, J editors. Genetics of mental disorders Part II: clinical issues. Bailliere’s Clinical Psychiatry, International Practice and Research. London: Bailliere Tindall; 1996. p. 1–13.Google Scholar
Brown, GAndrews, BBifulco, AVeiel, H. Self-esteem and depression. 1. Measurement issues and prediction of onset. Soc Psychiatry Psychiatr Epidemiol 1990;25:200–9.Google ScholarPubMed
Bauwens, FTracy, APardoen, DVan der Elst, MMen-dlewicz, J. Social adjustment of remitted bipolar and unipolar out-patients. A comparison with age- and sex-matched controls. Br J Psychiatry 1991;159:239–44.CrossRefGoogle ScholarPubMed
Pardoen, DBauwens, FTracy, AMartin, FMendlewicz, J. Self-esteem in recovered bipolar and unipolar out-patients. Br J Psychiatry 1993;163:755–62.Google ScholarPubMed
Beck, AT. Depression: clinical, experimental and theoretical aspects. New York: Harper & Row; 1967.Google Scholar
Winters, KCNeale, JM. Mania and low selfesteem. J Abnormal Psychol 1985;94:282–90.CrossRefGoogle Scholar
Miller, PMKreitman, NBIngham, JGSashidharan, SP. Selfesteem, life stress and psychiatric disorder. J Affect Disord 1989;17:65–75.CrossRefGoogle Scholar
Brown, GBifulco, AVeiel, HAndrews, B. Self-esteem and depression. 2. Social correlates of self-esteem. Soc Psychiatry Psychiatr Epidemiol 1990;25:225–34.CrossRefGoogle Scholar
Bothwell, RScott, J. The influence of cognitive variables on recovery in depressed inpatients. J Affect Disord 1997;43:207–12.CrossRefGoogle ScholarPubMed
Ezquiaga, EGarcia, APallares, TBravo, MF. Psychosocial predictors of outcome in major depression: a prospective 12-month study. J Affect Disord 1999;52:209–16.CrossRefGoogle ScholarPubMed
Staner, LTracy, ADramaix, MGenevrois, CVanderelst, MVilane, A et al. Clinical and psychosocial predictors of recurrence in recovered bipolar and unipolar depressives: a one-year controlled prospective study. Psychiatry Res 1997;69:39–51.Google ScholarPubMed
Serretti, ACavallini, MCMacciardi, FNamia, CFranchini, LLipp, O et al. Social adjustment and self-esteem in remitted patients with mood disorders. Eur Psychiatry 1999;14:137–42.Google ScholarPubMed
Shapira, BZislin, JGelfin, YOsher, YGorfine, MSouery, D et al. Social adjustment and self-esteem in remitted patients with unipolar and bipolar affective disorder: a case-control study. Compr Psychiatry 1999;40:24–30.Google ScholarPubMed
Dohrenwend, BPLevav, IShrout, PESchwartz, SNaveh, GLink, BG et al. Socioeconomic status and psychiatric disorders: the causation-selection issue. Science 1992;255:946–52.Google ScholarPubMed
Post, RM. Transduction of psychosocial stress into the neurobiology of recurrent affective disorder. Am J Psychiatry 1992;149:999–1010.Google ScholarPubMed
Coryell, WScheftner, WKeller, MEndicott, JMaser, JKlerman, GL. The enduring psychosocial consequences of mania and depression. Am J Psychiatry 1993;150:720–7.Google ScholarPubMed
Kienhorst, CWDe Wilde, EJVan Den Bout, JDiekstra, RFWolters, WH. Characteristics of suicide attempters in a population-based sample of Dutch adolescents. Br J Psychiatry 1990;156:243–8.CrossRefGoogle Scholar
Angst, JDegonda, MErnst, C. The Zurich Study: XV. Suicide attempts in a cohort from age 20 to 30. Eur Arch Psychiatry Clin Neurosci 1992;242:135–41.Google Scholar
De Man, AFLeduc, CPLabreche-Gauthier L. Correlates of suicide ideation in French-Canadian adults and adolescents: a comparison. J Clin Psychol 1992;48:811–6.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
Overholser, JCAdams, DMLehnert, KLBrinkman, DC. Self-esteem deficits and suicidal tendencies among adolescents. J Am Acad Child Adolesc Psychiatry 1995;34:919–28.Google ScholarPubMed
Plutchnik, RBotsis, AJVan Praag, HM. Psychopathology, self-esteem, sexual and ego functions as correlates of suicide and violence risk. Arch Suicide Res 1995;1:1–12.Google Scholar
Van Gastel, ASchotte, CMaes, M. The prediction of suicidal intent in depressed patients. Acta Psychiatr Scand 1997;96:254–9.CrossRefGoogle ScholarPubMed
Vilhjamsson, RKristjansdottir, GSveinbjarnardottir, E. Factors associated with suicide ideation in adults. Soc Psychiatry Psychiatr Epidemiol 1998;33:97–103.Google Scholar
Beautrais, ALJouce, PRMulder, RT. Personality traits and cognitive styles as risk factors for serious suicide attempts among young people. Suicide Life Threat Behav 1999;29:37–47.Google ScholarPubMed
Hawton, KKingsbury, SSteinhardt, KJames, AFagg, J. Repetition of deliberate self-harm by adolescents: the role of psychological factors. J Adolesc 1999;22:369–78.CrossRefGoogle ScholarPubMed
Nasser, EHOverholser, JC. Assessing varying degrees of lethality in depressed adolescent suicide attempters. Acta Psychiatr Scand 1999;99:423–31.CrossRefGoogle ScholarPubMed
Ahrens, BLinden, M. Is there a suicidality syndrome independent of specific major psychiatric disorder? Results of a split half multiple regression analysis. Acta Psychiatr Scand 1996;94:79–86.CrossRefGoogle Scholar
Souery, DLipp, OSerretti, AMahieu, BRivelli, SKCavallini, C et al. European Collaborative Project on Affective Disorders: interactions between genetic and psychosocial vulnerability factors. Psychiatr Genet 1998;8:197–205.Google ScholarPubMed
World Health Organization. Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Geneva: World Health Organization; 1992.Google Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines, 1992.Google Scholar
Rosenberg, M. The measurement of self-esteem. In: Rosenberg, M editor. Society and the adolescent self-image. New Jersey: Princeton University Press; 1965. p. 16–35.CrossRefGoogle Scholar
Weissman, MMBothwell, S. Assessment of social adjustment by patient self-report. Arch Gen Psychiatry 1976;33:1111–5.CrossRefGoogle ScholarPubMed
Robson, PJ. Self-esteem. A psychiatric view. Br J Psychiatry 1988;153:6–15.CrossRefGoogle ScholarPubMed
Ingham, JGKreitman, NBMiller, PMSashidharan, SPSurtees, PG. Self-appraisal, anxiety and depression in women. A prospective enquiry. Br J Psychiatry 1987;151:643–51.Google ScholarPubMed
Perugi, GMaremmani, IMcNair, DMCassano, GBAkiskal, HS. Differential changes in areas of social adjustment from depressive episodes through recovery. J Affect Disord 1988;15:39–43.CrossRefGoogle ScholarPubMed
Hays, RDWells, KBSherbourne, CDRogers, WSpritzer, K. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry 1995;52:11–9.CrossRefGoogle ScholarPubMed
Cannon, MJones, PGilvarry, CRifkin, LMcKenzie, KFoerster, AMurray, RM. Premorbid social functioning in schizophrenia and bipolar disorder: similarities and differences. Am J Psychiatry 1997;154:1544–50.Google ScholarPubMed
Blairy, SSouery, DPapadimitriou, GNDikeos, DGLerer, BKaneva, R et al. Association between unemployment and social adjustment and self-esteem in bipolar patients compared to normal subjects. World Federation of Societies of Biological Psychiatry, European Regional Congress, Florence, Italy. Abstract Book; 1999 n. 74.Google Scholar
Gitlin, MJSwendsen, JHeller, TLHammen, C. Relapse and impairment in bipolar disorder. Am J Psychiatry 1995;152:1635–40.Google ScholarPubMed
Bauwens, FPardoen, DStaner, LDramaix, MMendlewicz, J. Social adjustment and the course of affective illness: a one-year controlled longitudinal study involving bipolar and unipolar out-patients. Depress Anxiety 1998;8:50–7.3.0.CO;2-2>CrossRefGoogle Scholar
Moos, RHCroncite, RC. Symptom-based predictors of a 10-year chronic course of treated depression. J Nerv Ment Dis 1999;187:360–8.CrossRefGoogle ScholarPubMed
Nierenberg, AAGrossbard, SJFava, MRosenbaum, JF. Social adjustment does not predict depressive relapse during continuation fluoxetine therapy. J Affect Disord 1995;34:73–7.Google Scholar
Matussek, PWolfgang, PD. Personality attributes of depressive patients. Arch Gen Psychiatry 1983;40:783–90.Google ScholarPubMed
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