Correlation between emotion dysregulation and mood symptoms of bipolar disorder: A systematic review and meta-analysis

Vincenzo Oliva*, Michele De Prisco, Giovanna Fico, Chiara Possidente, Lydia Fortea, Laura Montejo, Gerard Anmella, Diego Hidalgo-Mazzei, Iria Grande, Andrea Murru, Michele Fornaro, Andrea de Bartolomeis, Alyson Dodd, Guiseppe Fanelli, Chiara Fabbri, Alessandro Serretti, Eduard Vieta, Joaqium Radua

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Emotion dysregulation (ED) is a transdiagnostic construct characterized by difficulties regulating intense emotions. People with bipolar disorder (BD) are more likely to show ED and use maladaptive emotion regulation strategies than adaptive ones. However, little is known about whether ED in BD is a trait or it is rather an epiphenomenon of mood symptoms.

We conducted a systematic review and meta-analysis of the evidence across major literature databases reporting correlations between measures of emotion regulation (overall ED and different emotion regulation strategies) and measures of depressive and (hypo)manic symptoms in BD from inception until April 12th, 2022.

Fourteen studies involving 1371 individuals with BD were included in the qualitative synthesis, of which 11 reported quantitative information and were included in the meta-analysis. ED and maladaptive strategies were significantly higher during periods with more severe mood symptoms, especially depressive ones, while adaptive strategies were lower.

ED significantly correlates with BD symptomatology, and it mainly occurs during mood alterations. ED may be a target for specific psychotherapeutic and pharmacological treatments, according to precision psychiatry. However, further studies are needed, including patients with mood episodes and longitudinal design, to provide more robust evidence and explore the causal direction of the associations.
Original languageEnglish
Pages (from-to)472-490
Number of pages19
JournalActa Psychiatrica Scandinavica
Issue number6
Early online date22 Sept 2023
Publication statusPublished - 1 Dec 2023

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