Relationship of Intolerance of Uncertainty and Attachment Styles with the Clinical Features of Bipolar Disorder in Remission

Objective: The intolerance of uncertainty and attachment styles may predict the severity and clinical characteristics of bipolar disorder. In this study, we aimed to investigate these features in remitted bipolar patients. Method: This cross-sectional descriptive study included 150 BPD patients who were followed up at the outpatient clinics of Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Diseases. After the evaluation for the inclusion/exclusion criteria, scores on the Young Mania Rating Scale and the Hamilton Depression Rating Scale were determined to confirm the state of remission. A sociodemographic data form, the Intolerance of Uncertainty Scale (IUS-12), the Relationship Scales Questionnaire (RSQ), the Inventory of Close Relationship Experiences 2 (ICRE-2), the Suicidal Behavior Questionnaire (SBQ) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-2) were used to acquire data. Results: Patients with a history of two or more suicidal attempts had significantly increased scores on the ICRE-2 avoidant subscale (p=0.001). Their scores on the ICRE-2 anxious subscale positively correlated with those on the IUS-12 prospective anxiety (p=0.000), and inhibitory anxiety (p=0.000) subscales. The linear regression model including the scores on the ICRE-2 avoidant and anxious subscales, the IUS-12 prospective anxiety and inhibitory anxiety subscales and the WHODAS-2 was predictive of the number of suicide attempts. Conclusion: The number of suicide attempts might be higher in BPD patients with avoidant or anxious attachment styles, high intolerance of uncertainty and high levels of disability.