Body image concerns in bipolar I and II disorders: their relationships with personality styles and affective states

Body image concerns are associated with the poor prognosis of bipolar disorder, but it is unknown whether bipolar I (BD I) and II (BD II) types differ in these concerns and their associations with personality styles or affective states.

We therefore invited 89 BD I, 91 BD II patients, and 159 healthy volunteers to undergo the tests of the Body Image Concern Scale (BICS), the Mood Disorder Questionnaire, the Hypomania Checklist - 32, the Plutchik - van Praag Depression Inventory, and the Parker Personality Measure.

Both BD I and BD II displayed higher scores of ongoing affective states and of personality disorder functioning styles than healthy controls did. BD II scored higher on all six BICS scales than controls did, and higher on five than BD I did. The depressive measure predicted four, and Dependent style predicted three BICS scales in BD I; and the depressive measure predicted all six BICS scales, hypomanic measure predicted one, and Avoidant style predicted one in BD II.

Body image concerns and their associations with the affective states and personality styles were different in BD I and BD II, suggesting different pathological mechanisms, clinical symptom severities and managements for the two types of bipolar disorder.