Functional Impairment, Attachment, and Affective Temperaments in Euthymic Patients with Bipolar Disorder

Functional impairment in euthymic patients with bipolar disorder is a compelling issue, and revealing unknown related factors with functional impairment is a substantial topic. We aimed to assess the effects of clinical factors, affective temperaments, and attachment on overall functioning in euthymic patients with bipolar disorder.

Sixty-three patients with bipolar disorder and 61 healthy controls participated in this study. The assessment involved Hamilton Depression Rating Scale; Young Mania Rating Scale; Relationship Scales Questionnaire; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego; and Functioning Assessment Short Test.

Secure attachment scores were significantly higher in the control group than in the bipolar disorder group. Depressive, anxious, and cyclothymic temperament scores were significantly higher in the bipolar disorder group. In the bipolar disordergroup higher occupational, cognitive, autonomy, interpersonal relationships, and leisure subdomain and overall functional impairment scores were found than in the healthy control group. Secure attachment scores were significantly and negatively correlated with anxious and depressive temperaments. Secure attachment scores were positively and significantly correlated with hyperthymic temperament scores. Years of education; subclinical depressive symptoms; secure attachment; and cyclothymic, irritable, depressive, hyperthymic, and anxious temperaments were all significantly correlated with the overall functional impairment in the patient group. The cyclothymic and anxious temperament positively predicted the overall functional impairment in the bipolar group, while the secure attachment negatively predicted the overall functional impairment in the regression analysis.

The results suggest that, when following up the patients with bipolar disorder in relation to functional impairment, secure attachment, cyclothymic, and anxious temperaments should be taken into consideration.