title: Self-esteem in remitted bipolar disorder patients: a meta-analysis.
abstract: OBJECTIVE
  Low self-esteem has been found to be a risk factor for depression in major depressive disorder (MDD). In contrast, the role of self-esteem in bipolar disorder (BD) is still uncertain. In order to examine the characteristics of self-esteem in BD, we synthesized studies comparing self-esteem in BD patients with self-esteem in MDD patients and in normal controls.
  
  
  METHODS
  Database searches and identification of studies were conducted by two of the authors independently. Remission of BD and MDD was a major selection criterion. The results were generated through meta-analyses.
  
  
  RESULTS
  Random-effects models of 19 between-group comparisons (N= 1,838) suggested that the self-esteem of remitted BD patients was significantly lower than that of normal controls (Cohen's d= -0.83), while significantly higher than that of remitted MDD patients (Cohen's d= 0.54). Fail-safe numbers and tests for funnel plot asymmetry indicated that the results were robust and unlikely to reflect publication biases. Additional studies indicated that self-esteem may take a fluctuating course during remission of BD.
  
  
  CONCLUSIONS
  By revealing that BD patients do experience low self-esteem, the findings implicate a need for further understanding the causes and therapeutic impact of such abnormality in BD.
authors.affiliation: Department of Psychology, Aarhus University, Denmark. kahr@psy.au.dk
authors.forename: Kristine Kahr
authors.initials: KK
authors.lastname: Nilsson
authors.forename: Carsten René
authors.initials: CR
authors.lastname: Jørgensen
authors.forename: Tom K J
authors.initials: TK
authors.lastname: Craig
authors.forename: Krista Nielsen
authors.initials: KN
authors.lastname: Straarup
authors.forename: Rasmus W
authors.initials: RW
authors.lastname: Licht
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology*; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000523:psychology; D006801:Humans; D012649:Self Concept