生活事件、社会支持与双相情感障碍患者症状复发的相关研究

目的探讨生活事件和社会支持与双相情感障碍患者症状复发的关系,为有针对性地实施干预提供依据。方法选取在中山市第三人民医院住院的符合《国际疾病分类(第10版)》(ICD-10)双相情感障碍诊断标准的70例患者为研究组,将研究组的健康家庭成员中与患者在性别、年龄、受教育程度等方面相近者作为对照组,共70人。采用生活事件量表(LES)和社会支持评定量表(SSRS)对两组人群进行测评。结果双相情感障碍患者与对照组人群的社会支持的情况差异有统计学意义(P0.05),这种差异主要体现在客观支持方面(P0.05),在主观性评价和对支持的利用度方面差异无统计学意义(P0.05)。生活事件对双相情感障碍患者的影响与对照组相比差异有统计学意义(P0.05)。经历负性生活事件,尤其是在家庭和工作方面发生的负性生活事件,对患者有明显的影响(P0.05)。回归分析显示患者症状复发的可能性与SSRS的客观支持评分呈负相关(OR=0.69)、与负性生活事件呈正相关(OR=1.05)。结论负性生活事件的影响程度和能够获得的客观社会支持程度是影响双相情感障碍患者症状复发的重要因素。     

情感性障碍与生活事件和社会支持的关系

目的 了解生活事件和社会支持与情感性障碍的关系。方法 采用生活事件量表和社会一表作评定工具，地３２例情感性障碍与９６例正常人进行研究。结果 情感性障碍患者负性称独立性生活事件的频度及ＬＥＵ总值均显著高于对照组，而情感性障碍社会支持量表分明显低于对照组，结论 生活事件和社会支持不足与情感性障碍的发病密切相关。     

生活事件、社会支持与自杀未遂

目的 :了解生活事件、社会支持对自杀行为的影响。　方法 :使用生活事件量表、社会支持量表对 10 0例自杀未遂者进行评定。　结果 :10 0例的生活事件频度 2 .81,生活事件紧张总值为 6 5 .0 3±4 0 .0 0。最常见的生活事件有人际冲突 ,夫妻矛盾 ,恋爱失败 ,工作压力 ,躯体疾病等。社会支持总分 38.15± 6 .74 ,客观支持 9.76± 2 .15 ,主观支持 2 0 .72± 4 .12 ,对支持利用度 7.6 2± 2 .10。　结论 :自杀未遂病人经历较多的生活事件 ,有一部分自杀未遂者对支持的利用度较差     

个性特征、生活事件及社会支持程度与紧张性头痛的关系研究

紧张性头痛(tension-type headache,TTH)是一种最常见的慢性头痛.现代医学认为TTH也是心身疾病的一种,其病因和发病机理不清.根据许多文献报道,其发病与情绪因素有密切关系,心理应激对TTH的发生、发展亦有一定影响[1].本文对TTH患者的个性特征、负性生活事件、社会支持程度及其与TTH发生的关系进行了探讨,以期为TTH的防治提供依据.     

负性生活事件与大学生抑郁情绪的关系:社会支持的中介与调节作用

目的探讨负性生活事件与大学生抑郁情绪的相关性以及社会支持在负性生活事件与抑郁情绪之间的作用,为改善大学生的抑郁情绪提供有效措施。方法于2017年1月和3月,在山东省济南市和烟台市各抽取一所高校,采用整群抽样方法选取600名在校大学生,使用流调中心抑郁量表(CES-D)、青少年生活事件量表(ASLEC)和社会支持评定量表(SSRS)对其进行评定。结果 CES-D与ASLEC评分呈正相关(r=0.271,P0.05),CES-D评分与SSRS的客观支持、主观支持和对支持的利用度评分均呈负相关(r=-0.127、-0.239、-0.215,P均0.05)。主观支持在负性生活事件与抑郁情绪之间的中介作用显著(P0.01);主观支持和客观支持在负性生活事件与抑郁情绪之间的调节作用显著(P0.05或0.01)。结论负性生活事件对大学生的抑郁情绪有正向预测作用,主观支持在负性生活事件和抑郁情绪之间起部分中介作用,主观支持、客观支持在负性生活事件与抑郁情绪之间起调节效应。     

社会支持对躯体形式障碍患者疗效的影响

目的探讨社会支持对躯体形式障碍患者疗效的影响。方法采用自制的一般情况调查表、汉密尔顿抑郁量表（HAMD，17项）及社会支持评定量表对46例躯体形式障碍患者（研究组）以及正常志愿者（对照组）进行测查，用SSRIs类抗抑郁剂与非典型抗精神病药对患者进行治疗，三个月后再次用HAMD进行评定，分析社会支持对疗效的影响。结果研究组社会支持利用度显著低于对照组（P〈0．01），社会支持好的躯体形式障碍患者其HAMD减分率显著高于社会支持差的患者（P〈0．05）。结论躯体形式障碍患者社会支持利用度低，而社会支持程度影响疗效，在药物治疗的同时要加强心理治疗，提高患者的社会支持利用度。     

精神分裂症的发病与生活事件和社会支持的相关性分析

目的 了解生活事件和社会支持与精神分裂症的关系。方法 采用生活事件和社会支持量表作评定工具,对200例精神分裂症与32例心境障碍和200例正常人进行对照研究。结果 精神分裂症患者负性和独立性生活事件的频度及LEU总值均显著高于正常人组,社会支持量表分明显低于正常人组。而与心境障碍组比较无显著差异。结论 生活事件和社会支持不足与精神分裂症的发病密切相关。     

躯体形式障碍患者生活事件的研究

目的：探讨生活事件、防御机制和社会支持在躯体形式障碍发病中的作用。方法：对60例躯体形式障碍（患者组）与60名健康者（对照组）采用自制的一般情况调查表、汉密尔顿抑郁量表（HAMD,17项）、生活事件量表（LES）、防御方式问卷（DSQ）及社会支持评定量表进行对照研究。结果：患者组生活事件的频度及严重度、不成熟防御机制评分显著高于对照组,而社会支持利用度对照组显著高于患者组。结论：躯体形式障碍患者病前经历了更多、更严重的生活事件,多采用不成熟的防御机制,社会支持的利用度不够。     

新冠肺炎疫情压力与社会适应：忍耐和社会支持的中介作用

目的 考察新冠肺炎（COVID-19）疫情压力对大学生社会适应的影响,以及忍耐和社会支持在其中的中介作用,并比较忍耐与社会支持中介效应的差异。方法 通过整群随机取样选取3 219名大学生,采用COVID-19疫情压力问卷、社会适应能力诊断量表（SAI）、忍耐问卷（PQ）和社会支持评定量表（SSRS）进行评定,应用SPSS的Process插件进行中介效应检验。结果 大学生COVID-19疫情压力问卷评分与PQ和SSRS评分均呈正相关（r=0.297、0.229,P均<0.01）,与SAI评分呈负相关（r=-0.430,P<0.01）,PQ和SSRS评分与SAI评分均呈正相关（r=0.374、0.283,P均<0.01）,PQ与SSRS评分呈正相关（r=0.271,P<0.01）。忍耐在COVID-19疫情压力与社会适应之间具有部分中介作用（β=0.049,95% CI：0.039~0.062）,社会支持在COVID-19疫情压力与社会适应之间具有部分中介作用（β=0.016,95% CI：0.009~0.025）。结论 COVID-19疫情压力对大学生社会适应具有负性影响,忍耐和社会支持对此负性作用起缓冲作用,且忍耐的中介效应更明显。     

Social support and social strain in inter-episode bipolar disorder

Eidelman P, Gershon A, Kaplan K, McGlinchey E, Harvey AG. Social support and social strain in inter‐episode bipolar disorder.
Bipolar Disord 2012: 14: 628–640. © 2012 The Authors.
Journal compilation © 2012 John Wiley & Sons A/S. Objectives: This study focused on social support and social strain and their cross‐sectional associations with instabilities in sleep and social rhythms in inter‐episode bipolar disorder (BD). Methods: Thirty‐five adults diagnosed with inter‐episode BD type I and 38 healthy controls completed measures of perceived social support and social strain. Group differences in support and strain were examined. Within the BD group, instabilities in sleep and social rhythms were assessed with 28 days of daily diary and actigraphy. Correlation and regression analyses were used to examine cross‐sectional and prospective associations between social support, social strain, instabilities in sleep and social rhythms, and mood symptoms. Results: The BD group reported lower social support and higher social strain than the control group. Additionally, social strain was positively correlated with manic and depressive symptoms in the BD group. Furthermore, there was a cross‐sectional association between social support and more stable sleep on actigraphy in the BD group, although social support did not predict future sleep instability. Conclusions: These results indicate that inter‐episode BD is associated with deficient social support and elevated social strain compared to controls, and that this may be due to persistent inter‐episode mood symptoms. Social strain may be particularly important given its association with manic and depressive symptoms. The results also raise the possibility that sleep instability is related to poor social support in BD.     

Differential effects of depression and mania symptoms on social adjustment: prospective study in bipolar disorder

Morriss R, Yang M, Chopra A, Bentall R, Paykel E, Scott J. Differential effects of depression and mania symptoms on social adjustment: prospective study in bipolar disorder.
Bipolar Disord 2013: 15: 80–91. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd. Objectives: Previous studies of social adjustment in bipolar disorder have been cross‐sectional and small in sample size, have examined a limited number of roles, or were not controlled for baseline mood and other clinical, social, or treatment confounders. We aimed to prospectively explore the strength and stability of correlations between depression and mania‐type symptoms and impairment in a broad range of social adjustment roles and domains. Methods: Multilevel modeling analysis of correlation coefficients between depression and mania‐type symptoms with roles and domains of the modified social adjustment scale (overall, work, social/leisure, extended family, marital, parental social adjustment roles, performance, interpersonal behavior, friction, dependency, overactivity domains) was used. Interview assessments were made at eight‐week intervals beginning at eight weeks and continuing through 72 weeks after baseline in 253 patients in a multicenter randomized controlled trial. Results: After controlling for baseline mood episodes, and other clinical, social, and treatment variables, depression symptoms showed strong and stable correlations over time with performance, overall social adjustment, and the work role; and a moderate but stable relationship with interpersonal behavior. The relationships of depression symptoms with the other roles were weak, non‐significant, or not stable. For mania‐type symptoms, only the correlation with interpersonal friction was moderately strong and reasonably stable over time. Mood episodes, substance use disorder, and borderline/antisocial personality disorder increased role impairment, while employment and marriage mildly decreased it. Conclusions: Depression and mania‐type symptoms have specific effects on social adjustment in bipolar I disorder. Depression symptoms are correlated strongly with performance and moderately with interpersonal behavior, while mania‐type symptoms are correlated moderately with interpersonal friction.     

Correlations of quality of life with adverse effects of medication, social support, course of illness, psychopathology, and demographic characteristics in patients with panic disorder

Care of patients with panic disorder has raised quality-of-life (QOL) issues. The purpose of this study was to identify the level of QOL in patients with panic disorder and to examine the relationships between QOL and adverse effects of medication, social support, course of illness, psychopathology, and demographic characteristics. We recruited 57 patients with panic disorder from outpatient psychiatric clinics. We measured their QOL levels with the Short Form of the World Health Organization Questionnaire on Quality of Life-Taiwan Version (the WHOQOL-BREF Taiwan version) and examined the correlates of QOL. The analysis revealed that multiple factors were associated with poor QOL in patients with panic disorder, including severe adverse effects of medication for panic disorder, perceived low social support, severe current panic symptoms, total Beck Depression Inventory-II (BDI-II) score>/=17, young age, being unmarried, and early onset of panic disorder. The QOL of patients with panic disorder was correlated to multiple factors that were specific to individual subjects and influenced by interactions with treatment and the social environment. The results provide screening factors so that clinicians can intervene to improve QOL for their patients with panic disorder.     

Social adjustment based on reported behaviour in bipolar affective disorder

OBJECTIVES: To determine the effects of mood and additional clinical variables on different domains of current interviewer-rated social adjustment reflecting the reported behaviour of patients with bipolar disorder (BD). METHOD: Multi-center cross-sectional study employing multiple linear regression to investigate whether mood and other clinical features, previously linked to self-rated social adjustment, were associated with eight domains of interviewer-rated social adjustment in 253 BD patients. Baseline variables were entered sequentially in blocks representing current mood, demographic, current other psychiatric, past psychiatric and current treatment variables. RESULTS: Mood episode or symptoms together with five other variables (borderline/antisocial personality disorder, male gender, living alone, hypnotic drug and drugs for physical illness) were associated with impairment on two or more domains of interviewer-rated social adjustment. They explained up to 31% of the variance in social adjustment, although friction, dependence and overactivity were associated with a different pattern of variables. Hypomanic symptoms were associated with increased friction and worse social adjustment with the extended family in the whole sample but improved performance and social and leisure activities in patients who were not in acute bipolar episode. CONCLUSION: Clinicians may determine up to about 30% of outcome in current social adjustment in BD patients from the patient's current mood episode or symptoms and a small number of other clinical or demographic variables. Hypomanic episodes and symptoms usually worsen friction and overall social adjustment, but in patients who are not in acute episode, hypomanic symptoms can increase performance and social and leisure activities.     

Psychosocial predictors of major affective recurrences in bipolar disorder: a 4-year longitudinal study of patients on prophylactic treatment

A total of 21 recovered bipolar patients on prophylactic treatment were prospectively followed up for a period of 1 year. Data for major recurrences were retrospectively collected for an additional 3–year period. During the entire 4–year period, over half of the patients (52%) had no major affective recurrences. Eight patients experienced a major depressive episode, while only two experienced a manic one. Psychosocial and clinical variables were assessed at entry to the study. The effect of these variables on the subsequent 4–year illness course was analysed using survivorship curves. The results show that the following psychosocial variables significantly predicted the occurrence of a major affective episode: low level of social support, maladjustment in social and leisure activities, and poor quality of relationships with extended family. In contrast, clinical variables which characterize illness history were not significantly associated with major recurrences.     

Occupational status and social adjustment six months after hospitalization early in the course of bipolar disorder: a prospective study

Dickerson F, Origoni A, Stallings C, Khushalani S, Dickinson D, Medoff D. Occupational status and social adjustment six months after hospitalization early in the course of bipolar disorder: a prospective study. Bipolar Disord 2010: 12: 10–20. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S. Objectives: Bipolar disorder is often accompanied by poor functional outcomes, the determinants of which are not fully understood. We assessed patients with bipolar disorder undergoing a hospital admission early in the illness course and identified predictors of occupational status, overall social adjustment, and work adjustment six months later. Methods: This was a prospective longitudinal cohort study. During hospitalization patients were evaluated with a cognitive battery; symptoms, occupational history, and other clinical factors were also assessed. At six‐month follow‐up, patients’ symptom remission status was assessed; they were also evaluated as to their occupational status, overall social adjustment, and work adjustment. Multivariate analyses were used to identify predictors of these outcomes. Results: Among the 52 participants, the average rating of overall social adjustment at follow‐up was between mild and moderate maladjustment. While 51 had a history of working full time, only 28 (54%) worked full time at follow‐up. A total of 24 (46%) had symptoms that met criteria for a full depression or mania syndrome. In multivariate analyses, full‐time occupational status at follow‐up was predicted by the absence of baseline substance abuse. Better overall social adjustment was predicted by better performance on cognitive tasks of processing speed and by symptom remission; the latter variable also predicted work adjustment. Conclusions: Persons with bipolar disorder have limited occupational recovery and overall social adjustment six months after a hospital admission early in the illness course. Predictors vary among outcomes; performance on tasks of processing speed and the extent of symptom remission are independently associated with functional outcomes.     

Relationships between insight and psychosocial adjustment in patients with bipolar I disorder

OBJECTIVES: The aim of this cross-sectional study was to examine the relationships between insight and psychosocial adjustment in outpatients with bipolar I disorder in clinical remission. METHODS: Using the Schedule of Assessment of Insight (SAI) and its expanded version (SAI-E), we evaluated 50 consecutive patients with bipolar I disorder in remission to determine their level of insight. We also evaluated their psychosocial adjustment using the Community Life Scale. Relationships among psychosocial adjustment, insight, residual affective symptoms, and demographic and clinical characteristics were examined. RESULTS: The results of the multiple regression analysis indicated that having a higher total SAI or SAI-E insight score and having no residual affective symptoms were significantly associated with better psychosocial adjustment in patients with bipolar I disorder. CONCLUSIONS: In this cross-sectional study, better insight and less residual affective symptoms were correlated with good psychosocial adjustment. To address the causality issue, a longitudinal study is needed.     

精神分裂症和双相情感障碍住院患者家属的生活质量及社会支持状况

目的：探讨精神分裂症和双相情感障碍（躁狂发作或抑郁发作及混合发作）住院患者家属生活质量及社会支持状况。方法以精神分裂症和双相情感障碍住院患者的家属为研究对象,进行一般调查表（自制）、简明健康调查量表（SF－36）、社会支持评定量表（SSRS）等检测,并对结果进行统计分析。结果（1）精神分裂症和双相情感障碍住院患者家属生活质量的各项指标均低于全国平均水平,差异有统计学意义（P ＜0．01）。（2）精神分裂症和双相情感障碍住院患者家属社会支持总分与全国常模比较,差异无统计学意义（P ＞0．05）;患者家属文化程度越高,获得的社会支持情况越好,但差异无统计学意义（P ＞0．05）;双相情感障碍患者家人获得的社会支持状况好于精神分裂症患者家属,差异有统计学意义（ P＝0．049）。结论精神分裂症和双相情感障碍住院患者家属的生活质量令人担忧,这可能与疾病的特点有关。     

Social networks, social support and the type of depressive illness

We hypothesised that there would be greater deficiencies in the quality and quantity of close personal relationship and social support in "neurotic" than in "endogenous" depressives, and that the relation between support and recovery would be stronger in the former. One hundred and thirty men and women who contacted hospital psychiatric services with depression were interviewed, and 119 (92%) reinterviewed after approximately 4 months. The association between the type of depression and deficiencies in social relationship was not impressive. However, differences were apparent in the prognostic implications of social relationship. For "neurotic" depressives, about half the social support variables assessed were significantly related to outcome, whereas the only significant predictor for "endogenous" cases was the presence of a close confidant. The results argue for further research on social support in clinical samples of acute depression.     

Premorbid adjustment in first episode schizophrenia and schizoaffective disorders: a comparison of social and academic domains

OBJECTIVE: Recent evidence suggests that premorbid adjustment in schizophrenia and related disorders can be separated into social and academic domains. In this paper, we examine the correlates of and prognostic significance of social and academic premorbid adjustment in a sample of 113 patients. METHOD: Premorbid adjustment, symptoms and cognitive functioning were assessed at presentation for treatment and symptoms were re-assessed after a year of treatment. RESULTS: Females and those with a diagnosis of schizoaffective disorder were found to have better premorbid adjustment in the academic domain, but not in the social domain. Neurocognitive functioning was more consistently related to academic than social adjustment. Better social and academic premorbid adjustment was correlated with lower negative symptoms after 1 year of treatment, but neither was a significant predictor of positive symptoms. CONCLUSION: Social and academic premorbid adjustments show different relations to gender, specific diagnosis and neurocognitive functioning in schizophrenia and related disorders.