Impact of biological rhythms on perception of illness and cognitive flexibility in bipolar patients in remission

ABSTRACT

Our study aims to examine the possible mediating effects of biological rhythms on the relationship between illness perception, cognitive flexibility, and functionality in bipolar patients in remission. A total of 150 patients with bipolar disorder (BD) were enrolled. The sociodemographic data form, Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN), Brief Illness Perception Questionnaire (BIPQ), Cognitive Flexibility Scale (CFS), Young Mania Rating Scale, Montgomery and Asberg Depression Scale, Beck Anxiety Inventory, and Short Functionality Assessment Scale were applied to the patients in the study. The mean age of the patients was 42.10 ± 12.92 (SD). The participants were 48.7% (n = 73) female and 66.6% (n = 100) BD-I. There was a negative correlation between the total BRIAN score and favorable BIPQ scores and a positive correlation between the total BRIAN score and unfavorable BIPQ scores (except timeline). Additionally, multiple regression analyses revealed that the total BRIAN score could predict favorable BIPQ (except treatment control) and unfavorable BIPQ (except timeline) scores (p < 0.05). The total CFS score also could predict favorable BIPQ (treatment control) and unfavorable BIPQ scores (except timeline). The second step mediation analysis showed that biological rhythm mediated the relationship between illness perception and cognitive flexibility. Our study found that biological rhythms played a full mediating role in the relationship between the perception of illness and cognitive flexibility. In addition, worsening in biological rhythms in bipolar patients could cause negative beliefs and attitudes towards their diseases with an unfavorable clinical course. Therefore, regularity in biological rhythms should be highly recommended for bipolar patients.

KEYWORDS:

• Bipolar disorder
• illness perception
• biological rhythms

Acknowledgments

Our most sincere thanks to all those who participated in this study.

Author contribution

Study conception and design: H.K., Writing, software, formal analysis, original draft preparation: H.K., and S.Y. Writing, review, and editing: H.K., and S.Y.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical considerations

The research was approved by the Kırıkkale University Faculty of Medicine, Non-Invasive Research Ethics Committee 21.10.2021 date and 2021.10.24 decision number. The research was conducted according to the Helsinki principles.

Informed consent statement

Informed consent was obtained from all subjects involved in the study.

Additional information

Funding

No institution has provided funding for this research.