Emotion, self and psychopathology: Neural correlates of emotion regulation and self-reflection in mood disorders and schizophrenia

Emotion regulation is the ability to deal with emotional experiences in response to emotional events, which we encounter in our daily life continuously. Self-reflection is the ability to form a proper mental concept of oneself. Both these processes are important for social functioning and quality of life. However, problems in these processes have been commonly observed in patients with psychiatric disorders, including bipolar disorder, schizophrenia and major depressive disorder. Investigating abnormal processing of the brain during emotion regulation and self-reflection could enhance our understanding of these disorders. Therefore, in this thesis we addressed several questions related to these processes in these psychiatric disorders. First, we investigated whether patients with bipolar disorder and schizophrenia have abnormal brain responses during emotion regulation and self-reflective processing. Second, suicide could be seen as an extreme consequence of dysfunctional emotion regulation. The other question we investigated was whether there are structural brain differences underlying suicidal risk in major depressive disorder. We demonstrated that patients with bipolar disorder and schizophrenia both showed disturbances in brain areas/networks during emotion regulation and self-reflection, but not the same disturbances. In addition, we observed structural abnormalities in brain areas involved in emotion regulation in patients with suicidal risk and major depressive disorder. Understanding these functional and structural disturbances in patients with bipolar disorder, schizophrenia and major depressive disorder might help pave the way to develop better diagnostic procedures and more personalized treatments for these patients.