Abstract：
OBJECTIVE: Dysfunctional attitudes (DA) are higher in depression; however, less is understood about their role in bipolar disorder (BD). This paper aimed to explore the presence of DA in BD in comparison to clinical and non-clinical groups. Also explored were the associations between DA and mood states of depression, mania or euthymia in BD.
METHODS: A systematic review and meta-analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta-analysis. The quality of each study was rated.
RESULTS: The meta-analysis showed significantly higher DA in BD than healthy controls (d = .70). However, no difference was observed between BD and unipolar participants (d = -.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (d = -.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d = -.38).
CONCLUSIONS: These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go \'offline\' when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice-based implications are expanded on in the discussion.
METHODS: A systematic review and meta-analysis were conducted. A total of 47 articles were included in the systematic review of which 23 were included in the meta-analysis. The quality of each study was rated.
RESULTS: The meta-analysis showed significantly higher DA in BD than healthy controls (d = .70). However, no difference was observed between BD and unipolar participants (d = -.16). When reviewing mood state within BD, a significant mean difference was found between DA scores for euthymic and depressed participants (d = -.71), with those who were depressed scoring higher. Three studies found that psychological therapies significantly reduce DA in BD (d = -.38).
CONCLUSIONS: These findings imply not only that DA are both a characteristic of BD that is not as prevalent in healthy populations but also that a depressed mood state is associated with increased severity. This implies that DA could possibly go \'offline\' when mood symptoms are not present. Psychological therapies appear to reduce DA in BD. Implications for future research as well as practice-based implications are expanded on in the discussion.
摘要：
目的：抑郁症患者的功能失调态度（DA）较高；然而，对它们在双相情感障碍（BD）中的作用了解较少。本文旨在探讨与临床和非临床组相比，BD中DA的存在。还探讨了DA与抑郁情绪状态之间的关联，BD中的躁狂症或食欲症。
方法：进行系统评价和荟萃分析。共有47篇文章纳入系统评价，其中23篇纳入荟萃分析。对每项研究的质量进行评价。
结果：荟萃分析显示，BD中的DA明显高于健康对照组（d=0.70）。然而,BD和单极参与者之间没有观察到差异(d=-.16).当回顾BD内的情绪状态时，抑郁和抑郁参与者的DA评分之间存在显着差异（d=-.71），那些抑郁的人得分更高。三项研究发现，心理治疗可显著降低BD患者的DA（d=-.38）。
结论：这些发现不仅暗示DA是健康人群中不常见的BD的特征，而且抑郁情绪状态与严重程度增加有关。这意味着当情绪症状不存在时，DA可能会“离线”。心理治疗似乎可以减少BD中的DA。在讨论中扩展了对未来研究的影响以及基于实践的影响。
方法：进行系统评价和荟萃分析。共有47篇文章纳入系统评价，其中23篇纳入荟萃分析。对每项研究的质量进行评价。
结果：荟萃分析显示，BD中的DA明显高于健康对照组（d=0.70）。然而,BD和单极参与者之间没有观察到差异(d=-.16).当回顾BD内的情绪状态时，抑郁和抑郁参与者的DA评分之间存在显着差异（d=-.71），那些抑郁的人得分更高。三项研究发现，心理治疗可显著降低BD患者的DA（d=-.38）。
结论：这些发现不仅暗示DA是健康人群中不常见的BD的特征，而且抑郁情绪状态与严重程度增加有关。这意味着当情绪症状不存在时，DA可能会“离线”。心理治疗似乎可以减少BD中的DA。在讨论中扩展了对未来研究的影响以及基于实践的影响。
