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rumination in bipolar disorder evidence for an unquiet mind沉思在双相情感障碍的证据之心
Ghaznavi and Deckersbach Biology of Mood Anxiety Disorders 2012, 2:2
/content/2/1/2 Biology of
Mood Anxiety Disorders
REVIEW Open Access
Rumination in bipolar disorder: evidence for an
unquiet mind
*
Sharmin Ghaznavi and Thilo Deckersbach
Abstract
Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However,
recent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused
repetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated
with depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in
manic states is unique to bipolar disorder and challenges explanations put forward for why people ruminate. We
review the research on rumination in bipolar disorder and propose that rumination in bipolar disorder, in both
manic and depressed states, reflects executive dysfunction. We also review the neurobiology of bipolar disorder
and recent neuroimaging studies of rumination, which is consistent with our hypothesis that the tendency to
ruminate reflects executive dysfunction in bipolar disorder. Finally, we relate the neurobiology of rumination to the
neurobiology of emotion regulation, which is disrupted in bipolar disorder.
Keywords: bipolar disorder, rumination, executive functioning, emotion regulation
Introduction treatments, the diagnosis and management of bipolar
Bipolar disorder is characterized by episodes of mania or depression remain significant challenges [8
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