Self-discrepancies in bipolar disorder: comparison of manic, depressed, remitted and normal participants.

OBJECTIVES

To study the role of self-discrepancies in different phases of bipolar disorder (manic-depression).

METHOD AND

DESIGN

Patients with a diagnosis of bipolar disorder in three groups, currently depressed, currently manic or hypomanic, and currently in remission, together with healthy control participants, were administered a modified version of Higgins' Selves Questionnaire. Consistencies between the self-actual, self-ideal and self-ought representations were calculated, together with consistencies between the self-actual representation and the believed views of generalized others about the self.

RESULTS

In contrast to all other groups, bipolar depressed patients showed marked discrepancies between their self-actual and self-ideal representations, and between their self-actual and self-ought representations. Manic or hypomanic patients showed higher self-actual:self-ideal consistency than non-patient controls. The differences between the depressed participants and the other groups appeared to be accounted for by their very negative self-actual descriptions. Participants in all four groups showed high levels of consistency between self-perceptions and the believed perceptions of others about the self.

CONCLUSIONS

These findings confirm that beliefs about the self differ between different phases of bipolar disorder and are consistent with the hypothesis that the manic phase involves active avoidance of discrepancies between the self and self-ideals.