Patient and partner correlates of couple relationship functioning in bipolar disorder

Extensive research in unipolar depressed and population-based samples has shown cross-partner associations between depressive symptoms and relationship adjustment. Yet despite evidence that bipolar disorder (BPD) is a more chronic and severe illness than unipolar depression, that individuals with BPD are at risk for interpersonal dysfunction, and that critical, unsupportive relationships are predictive of the course of depressive symptoms in BPD, there have been limited efforts to understand the correlates of relationship functioning within BPD. The current study addresses this gap in the literature by examining the associations between the depressive and manic symptoms of individuals with BPD, their partner's depressive symptoms, and relationship functioning, using a multimethod, multi-informant approach. Results revealed that the depressive symptoms of the individual with BPD were associated with poorer relationship functioning, particularly when the partner without BPD also had elevated depressive symptoms. In addition, an interaction between the individual with BPD's depressive and manic symptoms was observed, such that manic symptoms were associated with increased observed hostility and poorer partner relationship adjustment, but only when depressive symptoms were also elevated. These effects persisted even after overall mental health of both partners was controlled.