Wesley Mareena Susan, Manjula M, Thirthalli Jagadisha
Department of Psychology, Christ University, Bengaluru, Karnataka, India.
Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India.
Indian J Psychol Med. 2018 Jan-Feb;40(1):52-60. doi: 10.4103/IJPSYM.IJPSYM_211_17.
Patients with bipolar disorder (BD), despite recovering symptomatically, suffer from several functional impairments even in remission. The actual causes of impaired functioning are less known.
The study aimed to examine the clinical and psychosocial determinants of functioning in patients with BD in remission. A cross-sectional single-group design was adopted ( = 150). Participants meeting the study criteria were screened with Mini-International Neuropsychiatric Interview Scale. The selected participants were administered various tools to assess the level of functioning and the clinical, psychosocial determinants of functioning.
The clinical characteristics of the sample included early age of onset of illness, presence of precipitating factors, fewer episodes, minimal comorbidities, history of psychotic episodes, family history of mental illness, good medication adherence, and low depression and mania scores. Psychosocial factors included higher stress and moderate social support and self-esteem in the sample. Poor functioning patients had a history of longer hospital stay and had greater scores on depression, mania, stress, and maladaptive coping styles than better functioning patients.
Higher depression, mania, stress, and maladaptive coping strategies were related to poor functioning, while higher medication adherence, self-esteem, and social support were related to better functioning.
双相情感障碍(BD)患者即使症状有所缓解,仍存在多种功能障碍,即便处于缓解期也是如此。功能受损的实际原因尚不太清楚。
本研究旨在探讨缓解期双相情感障碍患者功能的临床及社会心理决定因素。采用横断面单组设计(n = 150)。符合研究标准的参与者使用迷你国际神经精神访谈量表进行筛查。对选定的参与者使用各种工具来评估功能水平以及功能的临床、社会心理决定因素。
样本的临床特征包括发病年龄早、存在诱发因素、发作次数较少、合并症最少、有精神病发作史、有精神疾病家族史、药物依从性良好以及抑郁和躁狂评分较低。社会心理因素包括样本中的压力较高、社会支持和自尊水平中等。功能较差的患者住院时间较长,且在抑郁、躁狂、压力和适应不良应对方式方面的得分高于功能较好的患者。
较高的抑郁、躁狂、压力和适应不良应对策略与功能较差有关,而较高的药物依从性、自尊和社会支持与功能较好有关。