Objective To explore the relationship between inferiority complex and ventromedial prefrontal cortex（ vmPFC） neurometabolites and personality traits in patients with bipolar depression. Methods From February 2024 to March 2025， 40 patients with bipolar depression who were either outpatient or inpatient at the Department of Clinical Psychology of People's Hospital of Xinjiang Uygur Autonomous Region were selected as study subjects. Patients were grouped based on their inferiority complex scores on the 24-item Hamilton Depression Rating Scale（ HAMD-24）. Those with an inferiority complex score ＞ 1 were assigned to the inferiority complex group， while those with an inferiority complex score ≤ 1 were assigned to the non-inferiority complex group. Each group comprised 20 patients. General Information Questionnaire and Eysenck Personality Questionnaire were used to collect patients' general information and evaluate their personality traits. The 1H-magnetic resonance spectroscopy（ 1H-MRS） was used to detect the ratios of N-acetyl-aspartate （NAA）/creatine（ Cr）， choline（ Cho）/Cr， myo-inositol（ mI）/Cr， and glutamate/glutamine（ Glx）/Cr in the vmPFC. Results Patients with bipolar disorder experiencing inferiority complex had a mean mI/Cr value of 0.43（ 0.35， 0.52）， which was statistically lower than the 0.52（ 0.43， 0.59） in patients without inferiority complex（ Z=-2.124， P＜ 0.05）. Compared with non-inferiority complex group， inferiority complex group scored lower on introversion extraversion score［ （42.75±6.97） vs.（ 51.75±10.04）］， with a statistically significant difference（ t=3.294， P＜0.05）. Correlation analysis revealed that NAA/Cr in non-inferiority complex group were negatively correlated with disease duration and age（ r=-0.474， -0.511； both P＜0.05）， mI/Cr positively correlated with neuroticism scores（ r=0.576， P ＜ 0.01）， and Cho/Cr positively correlated with age（ r=0.613， P ＜ 0.01）， all differences were statistically significant. Multivariate Logistic regression analysis showed that introversion extroversion was an influencing factor of inferiority complex in patients with bipolar depression， with a statistical difference ［OR=0.870， 95%CI（ 0.782， 0.968）， P ＜ 0.05］. Conclusions Low mI/Cr values in the vmPFC may be associated with inferiority complex in patients with bipolar depression. The inferiority complex in patients with bipolar depression is associated with introversion extroversion personality traits， and extroversion may serve as a protective factor against this inferiority complex in such patients.