Residual subjective depressive symptoms and resilience in patients with bipolar disorder

Residual symptoms experienced by patients with bipolar disorder (BD) is a risk factor for illness relapse/recurrence, and these symptoms are associated with a lower quality of life. Resilience allows patients to cope with stress effectively and acts as a protective factor against relapse. Therefore, this study aimed to determine the relationship between resilience and residual subjective depressive symptoms in euthymic patients with BD.

A total of 49 euthymic patients with BD completed the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR) and the Connor-Davidson Resilience Scale (CD-RISC). Hierarchical multiple regression analysis was performed to investigate the association between QIDS-SR and CD-RISC scores.

The mean Clinical Global Impression for BD (CGI-BP) and QIDS-SR scores were 1.3 ± 0.5 and 8.0 ± 5.8, respectively. Although clinically stable according to objective assessment using the CGI-BP, patients with BD experienced residual subjective depressive symptoms. After adjusting for demographic and clinical characteristics, CD-RISC scores could predict QIDS-SR scores significantly in a hierarchical multiple regression. The association between CD-RISC and QIDS-SR scores did not differ according to CGI-BP scores.

The clinical status was objectively evaluated using the CGI-BP alone. This was a cross-sectional study with a relatively small number of patients with BD, complicating the determination of the exact causal relationship between residual depressive symptoms and resilience.

Higher levels of resilience appears to be associated with lower subjective residual depressive symptoms in euthymic patients with BD. Resilience could play a protective role against the residual subjective depressive symptoms experienced by clinically stable patients with BD.