Mindful Attention Awareness and Residual Mood and Anxiety Symptoms in Remitted Patients With Bipolar I Disorder

In bipolar disorder, residual mood symptoms often persist even during the euthymic period, impairing functionality in 30-60% of patients in clinical remission. Addressing residual symptoms is critical as they are linked to reduced functionality and subjective wellbeing. This cross-sectional study aimed to determine the relationship between mindful attention awareness (MASS) and residual symptom severity in bipolar I disorder.

This study included 100 patients with bipolar I disorder (BD-I) in remission, recruited consecutively from outpatient clinics between December, 2019 and March, 2020. The patients were evaluated using the sociodemographic data form, Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS), and Mindful Attention Awareness Scale (MAAS).

As the MAAS of the patients increases, their depressive symptoms decrease (p < 0.001). As the MAAS of the patients increases, their anxiety symptoms decrease (p < 0.001). No statistically significant relationship was found between the mindful attention awareness of the patients and their manic symptoms (p = 0.161). Two variables (HAM-D and Hamilton Anxiety Rating Scale Scores (HAM-A)) in the multiple linear regression model explain 21.8% of the change in MAAS score.

Residual depressive and anxiety symptoms are predictive of lower MAAS in bipolar I disorder. Incorporating strategies to manage residual mood symptoms and improve mindfulness may enhance functionality and facilitate complete remission. However, given the cross-sectional design and the lack of a control group, causal inferences cannot be made. Further longitudinal and interventional studies are needed to explore the efficacy of mindfulness-based approaches in BD-I and determine whether the observed associations are specific to this disorder.