Early maladaptive schemas and suicidal risk in inpatients with bipolar disorder

Psychiatry Res. 2019 Jan:271:351-359. doi: 10.1016/j.psychres.2018.11.067. Epub 2018 Dec 1.


The present study aimed to assess the associations of early maladaptive schemas (EMSs) and clinical factors (hypomanic/manic and depressive symptoms) with suicidal risk (current suicidal ideation and lifetime suicide attempts) in inpatients with bipolar disorder (BD). One hundred inpatients with BD completed the Young Schema Questionnaire-Short Form (YSQ-SF), the Bipolar Depression Rating Scale (BDRS), the Young Mania Rating Scale (YMRS), and the Beck Scale for Suicide Ideation (BSSI). 59% of patients had lifetime suicide attempts and 59% showed high suicidal risk (BSSI ≥ 6). BD patients with lifetime suicide attempts had higher scores on the entitlement and social isolation schemas, depression, and hypomanic/manic symptoms than those without such attempts. Patients with high suicidal risk had higher levels of depressive and hypomanic/manic symptoms as well as some EMSs than those without high suicidal risk. Logistic regression analyses revealed that hypomanic/manic symptoms as well as the entitlement and defectiveness schemas were significantly associated with current suicidal ideation. Also, the entitlement and social isolation schemas were associated with lifetime suicide attempts. These results suggest that the entitlement, social isolation, and defectiveness schemas may relate to suicidal risk in patients with BD.

Keywords: Bipolar disorder; Early maladaptive schemas; Lifetime suicide attempts; Suicidal risk.

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Bipolar Disorder / physiopathology*
  • Bipolar Disorder / psychology*
  • Female
  • Humans
  • Male
  • Risk
  • Social Isolation*
  • Suicidal Ideation*
  • Suicide, Attempted*