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Family transactions and relapse in bipolar disorder
I S Rosenfarb1, D J Miklowitz, M J Goldstein
1Department of Psychology and Family Studies, United States International University, 10455 Pomerado Road, San Diego, CA 92131, USA. irosenfa@usiu.edu
Family Process
|April 6, 2001
Summary
Bipolar disorder relapse risk increases with residual patient symptoms and critical family interactions post-hospitalization. Family support and criticism levels also predict relapse, indicating a bidirectional relationship.
Area of Science:
- Psychiatry
- Clinical Psychology
- Family Studies
Background:
- Bipolar disorder (BD) is a chronic mental illness characterized by mood swings.
- Understanding factors predicting relapse is crucial for effective treatment and patient management.
- Family dynamics may play a significant role in the short-term course of bipolar disorder.
Purpose of the Study:
- To investigate the association between patient symptoms and relatives' affective behavior during family interactions and bipolar disorder relapse.
- To explore the predictive value of observed family interactions on the short-term course of bipolar disorder post-manic episode.
Main Methods:
- Twenty-seven bipolar patients and their relatives participated in two 10-minute observed family interactions.
- Patient symptoms (e.g., odd thinking, grandiose thinking) and relatives' affective behaviors (e.g., criticism, support) were assessed.
- Relapse was monitored over a 9-month follow-up period.
Main Results:
- Patients exhibiting high levels of odd and grandiose thinking were more likely to relapse.
- High rates of harsh criticism and direct support from relatives were associated with relapse.
- A significant correlation was found between patients' odd thinking and relatives' harsh criticism during relapse periods.
Conclusions:
- Residual symptomatology in bipolar disorder patients during post-hospital family interactions predicts increased relapse risk.
- Relatives of relapsing patients tend to increase both positive and negative affective behaviors.
- A bidirectional relationship between patient symptoms and family coping styles is key in predicting bipolar disorder relapse.