Early Maladaptive Schemas: Relationship With Case Complexity in Mood and Anxiety Disorders

Background: Schema theory, developed for chronic, treatment-resistant patients, has been largely applied to personality disorders. However, many patients with other psychiatric disorders, including mood and anxiety disorders, also demonstrate elevated early maladaptive schemas (EMSs). Based on schema theory and clinical observations, individuals with greater case complexity would be expected to demonstrate higher EMS activation. Aim: This study examines EMSs as a function of case complexity in individuals with mood and anxiety disorders. Method: 69 patients consulting for mood or anxiety disorders completed the YSQ-S3 and a thorough intake assessment. The relationship between EMSs and case complexity is explored. Results: Although some EMSs are more strongly activated as a function of comorbidities and degree of functional impairment, the greatest difference is a function of multiaxial case complexity. Conclusion: Complex clinical presentations are associated with EMS activation. Case complexity should be considered when applying schema theory to mood and anxiety disorders. Schema therapy may be a useful treatment alternative particularly for the more complex cases.