Metacognitions and repetitive negative thinking in bipolar disorder and healthy controls: A comparative study.

Abstract Background Metacognitive deficits and repetitive negative thinking are poorly explored in bipolar disorder (BD). The majority of the published studies concerned patients with bipolar depression, without differentiating among BD subtypes. The most common dysfunctional metacognitions, measured with the Metacognition Questionnaire-30 (MCQ-30), were Negative Beliefs about the Uncontrollability and Danger of Worry (NB), Cognitive Confidence (CC) and Beliefs about the Need to Control Thoughts (NC). Worry and rumination also seem to influence every phase of BD. This study aimed to investigate metacognitions and repetitive negative thinking in euthymic patients with BD. Method Using the MCQ-30, the Penn State Worry Questionnaire (PSWQ) and the Ruminative Responses Scale (RRS), we compared 57 BD-I and 48 BD-II patients with 78 healthy controls. Results Both BD groups showed significantly higher NB, CC, NC and total MCQ-30 scores. ‘Positive Beliefs About Worry’ (PBW) showed a significantly higher score only in the BD-II group. Rumination scores were significantly higher in both patient samples. Worry did not show any significant differences between groups. Limitations The primary limitations are related to the size of the samples and the research design. Conclusions Our findings suggest that metacognitive deficits and negative repetitive thinking are associated with euthymic BD. Rumination, NB, CC, and TC may represent trait-dependent features related to the inter-episodic phase of the disorder. A higher PBW score seems to be a distinctive feature only for patients with euthymic BD-II. The results offer new perspectives in the psychotherapeutic treatment of these patients.