{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T05:06:34Z","timestamp":1772773594335,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,1,22]],"date-time":"2023-01-22T00:00:00Z","timestamp":1674345600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004281","name":"Narodowe Centrum Nauki","doi-asserted-by":"publisher","award":["Grant no. 2011\/03\/D\/NZ5\/06146"],"award-info":[{"award-number":["Grant no. 2011\/03\/D\/NZ5\/06146"]}],"id":[{"id":"10.13039\/501100004281","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Early Intervention Psych"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>There have been limited prospective investigations of early clinical markers involved in mood regulation and diagnosis change in young patients. This study aimed to evaluate the changes in impulsivity and defence mechanisms in patients with major depressive disorder (MDD) and bipolar disorder (BD) with acute symptoms and remission compared to healthy controls (HC), and possible psychological predictors of diagnosis conversion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy\u2010nine young MDD or BD patients and 40 HC were enrolled in a two\u2010year prospective study. A comprehensive clinical interview focused on clinical and psychological evaluation during follow\u2010up visits. The severity of depressive symptoms was evaluated using the Hamilton Depression Rating Scale (HDRS\u201017), whilst the Young Mania Rating Scale (YMRS) was used for hypo\/manic symptoms during each control visit. All patients completed the Defence Style Questionnaire (DSQ\u201040) and Barratt Impulsiveness Scale (BIS\u201011).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients used more immature defences, and had significantly higher total impulsivity scores than controls. BD patients had elevated motor and non\u2010planning impulsivity compared with HC and MDD subjects. Total and non\u2010planning impulsiveness remained elevated in euthymia in BD and MDD compared to HC. There were no statistically significant differences in total defence styles and impulsiveness scores at baseline vs. euthymia in MDD or BD patients groups. Significantly higher dissociation scores at baseline discriminated depressive patients who convert to BD in their diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with acute mood symptoms used more frequent immature defences and had significantly higher total impulsivity scores than healthy persons. A lack of differences in total defence styles and impulsiveness between patients with acute symptoms and after reaching euthymia in both MDD and BD groups indicates that they are independent of disease status. Dissociation defence mechanisms may be an early diagnostic indicator of BD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eip.13393","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T05:55:59Z","timestamp":1674453359000},"page":"1001-1011","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical assessment of impulsiveness and defence mechanisms in young patients with mood disorders in a two\u2010year prospective study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5955-986X","authenticated-orcid":false,"given":"Aleksandra","family":"Rajewska\u2010Rager","sequence":"first","affiliation":[{"name":"Department of Psychiatric Genetics, Chair of Psychiatry Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monika","family":"Dmitrzak\u2010Weglarz","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Genetics, Chair of Psychiatry Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Lepczynska","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Karol Jonscher Clinical Hospital Poznan University of Medical Sciences  Pozna\u0144 Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawel","family":"Kapelski","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Genetics, Chair of Psychiatry Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Pawlak","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Genetics, Chair of Psychiatry Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Skibinska","sequence":"additional","affiliation":[{"name":"Department of Psychiatric Genetics, Chair of Psychiatry Poznan University of Medical Sciences  Poznan Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,22]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199304000-00006"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1348\/147608309X464206"},{"key":"e_1_2_13_4_1","volume-title":"Stress, coping & development: An integrative perspective","author":"Carolyn A.","year":"2000"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.08.038"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.2018.16.3.262"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/00332747.2019.1579595"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.159.6.927"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-5215.2011.00522.x"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.5964\/ejop.v13i2.1090"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12556"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.2006.163.9.1633"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2044-8260.1967.tb00530.x"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.05.023"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bdi.12419"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/NMD.0b013e3181b3b224"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097-4679(200006)56:6<723::aid-jclp3>3.0.co;2-3"},{"key":"e_1_2_13_18_1","doi-asserted-by":"crossref","unstructured":"Lewis A. 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