Coping styles and personality traits in older age bipolar disorder living without prophylactic medication

Relapse prevention in bipolar disorder (BD) involves prophylactic medication, self-management, and optional adjunctive psychotherapy. Despite guideline recommendations, a significant number of patients with BD does not use prophylactic medication. How they manage their mood is unknown. We assessed the coping styles, personality traits, and the role of childhood trauma in Older Age Bipolar Disorder (OABD) living with and without prophylactic medication.

Cross-sectional data from two Dutch OABD cohorts (n = 280) was used to perform logistic regression analysis on coping styles (Utrecht Coping List) and personality traits (NEO Five Factor Inventory), in relation to living without prophylactic medication. The role of childhood trauma was assessed with correlation and interaction analysis. We identified the best predictors using LASSO regression.

Active problem solving (OR 1.25, 95 % CI [1.10-1.45]), passive reaction (OR 1.34, 95 % CI [1.10-1.66]), and comforting cognitions (OR 0.80, 95 % CI [0.65-0.96]) were associated with living without prophylactic medication, while personality traits were not associated. Childhood abuse interacted with active problem solving and passive reaction in prophylactic medication usage. The best predictive model accounted for 35.5 % of the variance in prophylactic medication usage, with active problem solving, passive reaction, extraversion, and neuroticism being positively associated, while comforting cognitions and openness were negatively associated.

In OABD, the coping styles active problem solving and passive reaction are associated with living without prophylactic medication, while comforting cognition is negatively associated. Future research should include a larger sample size of all ages and follow-up measurements to replicate our findings.