Causal modeling of recovery from bipolar I disorder based on reward sensitivity mediated by sleep disturbance and cognitive insight

The aim of this study was to investigate the causal modeling of recovery from bipolar I disorder based on reward sensitivity and with the mediating role of sleep disturbance and cognitive insight. This cross-sectional study was performed by available sampling method on 126 patients with bipolar I disorder in the manic phase, which was referred to the psychiatric clinics of Yazd province in the period of October 2020 to May 2021, was performed. Sample subjects were reassessed for mania severity 30 days after completing the questionnaires and initial assessment. A researcher-made questionnaire, Clinical Global Impressions Scale for Bipolar Disorder, Young Mania Rating Scale, Emotional Auditory Verbal Learning Test, Daneman & Carpenter Working Memory Test, and the Sensitive to Reward and Sensitive to Punishment Scale were used to assess individuals. Data were analyzed using structural equation modeling and Smartpls-3 software. The results showed that the value of t-statistic for all pathways except the path of reward sensitivity to cognitive insight and the path of cognitive insight to recovery from the disorder, is higher than 1.96 and as a result are significant at 95% confidence level. It can be concluded that Reward sensitivity can directly and indirectly (through its effect on sleep disturbance) affect the recovery from bipolar I disorder. However, reward sensitivity through cognitive insight has no effect on recovery from bipolar I disorder.