Serravalle Lisa, Iacono Vanessa, Hodgins Sheilagh, Ellenbogen Mark A
Centre for Research in Human Development, Concordia University, Montréal, Canada.
Département de Psychiatrie, Université de Montréal, Montréal, Canada.
Int J Bipolar Disord. 2020 Feb 10;8(1):8. doi: 10.1186/s40345-019-0172-x.
Individuals with bipolar disorder (BD) often possess maladaptive traits and present with various difficulties in psychosocial functioning. However, little is known about the intimate partners of adults with bipolar disorder (BD) and how mental illnesses other than BD within couples may further complicate the picture. Such knowledge is needed to inform both couple and family interventions.
Participants were parents whose children were enrolled in a prospective study: 55 with BD and their partners, and 47 healthy control couples. All completed diagnostic interviews, and questionnaires describing personality traits, negative life events, coping skills, social support, marital adjustment and inter-partner verbal aggression. Parents with BD and healthy control parents were compared, as were the intimate partners. A series of exploratory analyses focused on the average measures within couples, with and without BD, and took account of comorbid personality disorders among those with BD and major depressive disorder among their partners.
Intimate partners of adults with BD, relative to healthy control partners, presented with more mental disorders, higher neuroticism, lower extraversion, more emotion-focused coping, smaller social networks, less satisfaction with their social networks, and little, satisfying social contact. Additionally, they reported less consensus and satisfaction in their marital relationships, and engaged in more verbal aggression towards their partners. Participants with BD showed similar, more extreme, characteristics. Marital distress and verbal aggression were greatest among couples with an adult having BD and a comorbid personality disorder or a partner with major depressive disorder.
This study contributes to the literature by demonstrating that both parents with BD and their intimate partners exhibit high levels of mental illness, maladaptive personality traits and psychosocial difficulties, thus limiting their partners' ability to provide support and stability in the these high risk families. Moreover, mental illnesses other than BD may contribute to marital problems within couples. Some statistical analyses, particularly those involving comorbid conditions, were under-powered in this study. As clinical implications, the current study suggests that both individuals with BD and their partners could benefit from interventions aimed at lowering emotionality and verbal aggression, and increasing social support and effective coping skills.
双相情感障碍（BD）患者通常具有适应不良的特质，并且在心理社会功能方面存在各种困难。然而，对于患有双相情感障碍的成年人的亲密伴侣以及夫妻中除双相情感障碍之外的其他精神疾病如何使情况更加复杂，我们所知甚少。了解这些知识对于指导夫妻和家庭干预都很有必要。
参与者是其子女参加一项前瞻性研究的父母：55对一方患有双相情感障碍的夫妻及其伴侣，以及47对健康对照夫妻。所有人都完成了诊断访谈，以及描述人格特质、负面生活事件、应对技巧、社会支持、婚姻调适和伴侣间言语攻击的问卷。对患有双相情感障碍的父母和健康对照父母进行了比较，对亲密伴侣也进行了比较。一系列探索性分析聚焦于有或没有双相情感障碍的夫妻内部的平均测量值，并考虑了患有双相情感障碍者的共病性人格障碍及其伴侣中的重度抑郁症。
与健康对照伴侣相比，患有双相情感障碍的成年人的亲密伴侣患有更多精神障碍、神经质得分更高、外向性得分更低、更多采用以情绪为中心的应对方式、社交网络更小、对其社交网络的满意度更低，并且很少有令人满意的社交接触。此外，他们报告在婚姻关系中的共识和满意度较低，并且对伴侣进行更多的言语攻击。患有双相情感障碍的参与者表现出类似但更极端的特征。在一方患有双相情感障碍且伴有共病性人格障碍或伴侣患有重度抑郁症的夫妻中，婚姻困扰和言语攻击最为严重。
本研究通过证明患有双相情感障碍的父母及其亲密伴侣都表现出高水平的精神疾病、适应不良的人格特质和心理社会困难，从而限制了其伴侣在这些高风险家庭中提供支持和稳定性的能力，为该领域文献做出了贡献。此外，双相情感障碍之外的精神疾病可能导致夫妻间的婚姻问题。本研究中的一些统计分析，特别是那些涉及共病情况的分析，效力不足。作为临床意义，当前研究表明，患有双相情感障碍的个体及其伴侣都可以从旨在降低情绪性和言语攻击、增加社会支持和有效应对技巧的干预中受益。
