Depression, mania in BD I have differential social adjustment effects

Jan 15 2013

By Mark Cowen, Senior medwireNews Reporter

Results from a UK study show that depression and mania symptoms have specific and differential effects on social adjustment in patients with bipolar disorder (BD).

Richard Morriss (University of Nottingham) and team found that depression symptoms have a negative effect on performance and interpersonal behavior, while mania symptoms increase interpersonal friction.

"Further research is required to understand how mood symptoms can lead to impairments in social adjustment domains such as performance, interpersonal behavior, and friction, and their interplay with other biological, psychological, social, and treatment factors," they comment in Bipolar Disorders.

The findings come from a study of 253 patients with BD I (n=238) or BD II (n=15), aged 20-75 years, who were interviewed every 8 weeks for 72 weeks.

Social adjustment (work, social/leisure, extended family, marital, parental social adjustment roles, performance, interpersonal behavior, friction, dependency, and overactivity) were assessed at each interview using the Social Adjustment Scale (SAS).

Depression and mania symptoms were also assessed at each interview using the Longitudinal Interval Follow-up Evaluation (LIFE-II).

After accounting for baseline variables, such as age, gender, marital status, living circumstances, work status, and socio-economic status, the team found that increased severity of depressive, but not manic, symptoms was significantly associated with reduced overall social adjustment scores over the study period.

Increased depressive symptom severity was also significantly associated with poorer scores for work adjustment, social and leisure role, performance, and interpersonal behavior.

Increased severity of mania symptoms, on the other hand, was only significantly associated with greater interpersonal friction.

"In this prospective study, we have shown that depression and mania-type symptoms in bipolar disorder have differential effects on social adjustment," Morriss and team summarize.

They conclude: "These results confirm that the active treatment of persistent residual bipolar depression or mania-type symptoms may be desirable if there are impairments in performance and interpersonal behavior or interpersonal friction, respectively, provided that such treatment does not involve excessive sedation."

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