Emotion regulation difficulties are associated with psychosocial functioning via trait anxiety levels in remitted bipolar disorder patients

Int J Psychiatry Clin Pract. 2025 Jun;29(2):51-56. doi: 10.1080/13651501.2025.2492159. Epub 2025 Apr 21.

Abstract

Objective: The aim of this study was to determine the effects of anxiety levels and emotion dysregulation on each other and their effects on psychosocial functioning in remitted BD patients.

Methods: Sixty-six patients with BD and 38 healthy controls were included in this study. All the patients were assessed with the Hamilton Depression Rating Scale, the Young Mania Rating Scale, the Bipolar Disorder Functioning Questionnaire, the State-Trait Anxiety Inventory (STAI) and the Difficulties in Emotion Regulation Scale (DERS). Healthy controls were only assessed with the STAI and the DERS.

Results: STAI and DERS scores were significantly higher in the patient group than in the control group. Higher scores of STAI and DERS were found to be associated with lower functionality in the patient group. The trait anxiety scores explained 22% of the variance in the psychosocial functionality scores of the patients while the total DERS score explained 51.5% of the variance in the trait anxiety scores. Patients on lithium treatment had less difficulty in regulating their emotions than those on valproic acid treatment.

Conclusions: In light of these findings, planning interventions for emotion regulation difficulties during the management of patients would reduce anxiety levels and contribute to improving patients' psychosocial functionality.

Keywords: Anxiety; bipolar disorder; emotion dysregulation; psychosocial functioning.

Plain language summary

Emotion dysregulation has a close relationship with anxiety and psychosocial functioning in remitted bipolar patients.Emotion dysregulation explained 51.5% of the varience in trait anxiety.Trait anxiety explained 22% of the varience in the functionality.Lithium users might have less difficulty in regulating their emotions.

MeSH terms

  • Adult
  • Affective Symptoms* / etiology
  • Affective Symptoms* / physiopathology
  • Antimanic Agents / pharmacology
  • Antimanic Agents / therapeutic use
  • Anxiety* / physiopathology
  • Bipolar Disorder* / complications
  • Bipolar Disorder* / drug therapy
  • Bipolar Disorder* / physiopathology
  • Bipolar Disorder* / psychology
  • Emotional Regulation* / physiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psychosocial Functioning*
  • Valproic Acid / pharmacology
  • Young Adult

Substances

  • Valproic Acid
  • Antimanic Agents