Metacognitive beliefs in unipolar and bipolar depression: a comparative study

The purpose of this study was to perform a comparative investigation of metacognitive beliefs regarding pathological worry in patients with unipolar and bipolar depressive disorder.

Those subjects with acute depressive episodes among patients diagnosed with major depressive disorder (unipolar) or bipolar disorder on the basis of DSM-IV diagnostic criteria (unipolar n = 51, bipolar n = 45), and healthy controls (n = 60), were included in the study. Participants were administered the Meta-Cognitions Questionnaire (MCQ-30) in order to determine metacognitive beliefs. The relationship between metacognitive beliefs and anxiety severity, depression severity and self-esteem in the unipolar and bipolar patients groups was then examined.

Scores for negative beliefs about worry concerning uncontrollability and danger and for beliefs about the need to control thoughts were higher in both the unipolar and bipolar depression groups than in the healthy controls (P < 0.05). Lack of cognitive confidence scores were higher in the bipolar group than in the healthy controls (P < 0.05). Metacognitive beliefs (to a greater extent in parameters in the bipolar group) were correlated with anxiety level, depression level and self-esteem in both patient groups.

In addition to metacognitive beliefs known to be associated with ruminations in unipolar and bipolar depression, metacognitive beliefs can also be seen in association with worry. Worry-associated metacognitive beliefs should be the subject of focus in the identification of metacognitive beliefs in depression patients and in metacognitive therapy in these patients.