Van Rheenen Tamsyn E, Rossell Susan L
Brain and Psychological Sciences Research Centre (BPsyC), School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University, Melbourne, Australia.
Brain and Psychological Sciences Research Centre (BPsyC), School of Health Sciences, Swinburne University, Melbourne, Australia; Cognitive Neuropsychiatry Laboratory, Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University, Melbourne, Australia.
J Affect Disord. 2014 Jun;162:134-41. doi: 10.1016/j.jad.2014.03.043. Epub 2014 Apr 1.
People with bipolar disorder (BD) experience significant psychosocial impairment. Understandings of the nature and causes of such impairment is limited by the lack of research exploring the extent to which subjectively reported functioning should be valued as an indicator of objective dysfunction, or examining the relative influence of neurocognition, social cognition and emotion regulation on these important, but different aspects of psychosocial functioning in the context of mania and depression symptoms. This study aimed to address this paucity of research by conducting a comprehensive investigation of psychosocial functioning in a well characterised group of BD patients.
Fifty-one BD patients were compared to 52 healthy controls on objectively and subjectively assessed psychosocial outcomes. Relationships between current mood symptoms, psychosocial function and neurocognitive, social cognitive and emotion regulation measures were also examined in the patient group.
Patients had significantly worse scores on the global objective and subjective functioning measures relative to controls. In the patient group, although these scores were correlated, regression analyses showed that variance in each of the measures was explained by different predictors. Depressive symptomatology was the most important predictor of global subjective functioning, and neurocognition had a concurrent and important influence with depressive symptoms on objective psychosocial function. Emotion regulation also had an indirect effect on psychosocial functioning via its influence on depressive symptomatology.
As this study was cross-sectional in nature, we are unable to draw precise conclusions regarding contributing pathways involved in psychosocial functioning in BD.
These results suggest that patients' own evaluations of their subjective functioning represent important indicators of the extent to which their observable function is impaired. They also highlight the importance of incorporating cognitive and emotion regulation assessments into clinical practice when working to reduce psychosocial dysfunction with patients diagnosed with BD.
双相情感障碍（BD）患者存在显著的社会心理功能损害。由于缺乏研究来探索主观报告的功能在多大程度上应被视为客观功能障碍的指标，或者在躁狂和抑郁症状背景下，考察神经认知、社会认知和情绪调节对这些重要但不同方面的社会心理功能的相对影响，因此对这种损害的性质和原因的理解有限。本研究旨在通过对一组特征明确的BD患者的社会心理功能进行全面调查，来解决这一研究不足的问题。
将51名BD患者与52名健康对照者在客观和主观评估的社会心理结果方面进行比较。还在患者组中检查了当前情绪症状、社会心理功能与神经认知、社会认知和情绪调节测量之间的关系。
相对于对照组，患者在整体客观和主观功能测量上的得分显著更差。在患者组中，尽管这些得分相关，但回归分析表明，每个测量指标的方差由不同的预测因素解释。抑郁症状是整体主观功能的最重要预测因素，神经认知与抑郁症状对客观社会心理功能有同时且重要的影响。情绪调节也通过其对抑郁症状的影响对社会心理功能产生间接影响。
由于本研究本质上是横断面研究，我们无法就BD患者社会心理功能的相关作用途径得出精确结论。
这些结果表明，患者对其主观功能的自我评估是其可观察功能受损程度的重要指标。它们还强调了在与被诊断为BD的患者合作以减少社会心理功能障碍时，将认知和情绪调节评估纳入临床实践的重要性。
