The Relationship of Perceived Social Support with Level of Insight and Treatment Adherence in Individuals Diagnosed with Schizophrenia and Bipolar Disorder
Abstract
Purpose: This study aims to examine the relationship between perceived social support, insight, and treatment adherence in patients with schizophrenia and bipolar disorder.
Materials and Methods: This study was conducted with 110 individuals, including 55 bipolar and 55 schizophrenia patients, who had been hospitalized in our clinic in the last 1 year and were in remission. Participants were administered a sociodemographic and clinical data form, Young Mania Rating Scale (YMDÖ), Clinical Global Impression Scale (CGI), Three Components of Insight Rating Scale (IÜBDÖ), Morisky Treatment Compliance Scale (MTUÖ) and Multidimensional Perceived Social Support Scale (MSPSS).
Results: The mean age was 40.47±12.96 for bipolar patients and 40.45±11.71 for schizophrenics. Perceived family, friend, significant others support, and total support was found to be higher (p=0.000, p=0.000, p=0.004, p=0.000, respectively) of bipolar patients, and the highest support was perceived from family, followed by friends and significant people. Although the groups did not differ in terms of treatment adherence (p=0.083), the insight score was significantly higher in bipolar patients (p=0.001). Groups were evaluated with hierarchical regression analysis in terms of factors affecting perceived social support. Gender, years of education, insight, and treatment adherence were found to be predictive of social support (p=0.04, p=0.01, p<0.001, p=0.01, respectively).
Conclusion: Informing caregivers (family, etc.) of bipolar and schizophrenic patients about the effect of social support on clinical outcome may reduce the burden of caregivers by contributing positively to insight and treatment compliance.
References
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- 2. Eker D, Arkar H, Yaldız H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turkish Journal of Psychiatry. 2001;12(1):17-25.
- 3. Kleindienst N, Engel R, Greil W. Psychosocial and demographic factors associated with response to prophylactic lithium. A systematic review for bipolar disorders. Psychol. Med. 2005;35(12):1685-1694.
- 4. Cohen AN, Hammen C, Henry RM, et al. Effects of stress and social support on recurrence in bipolar disorder. J. Affect. Disord. 2004;82(1):143-147.
- 5. Corrigan PW, Phelan SM. Social support and recovery in people with serious mental illnesses. Community Ment. Health J. 2004;40(6):513-523.
- 6. Hendryx M, Green CA, Perrin NA. Social support, activities, and recovery from serious mental illness: STARS study findings. J. Behav. Health Serv. Res. 2009;36(3):320-329.
- 7. Reddy M. Insight and psychosis. Indian J. Psychol. Med. 2015;37(3):257-260.
- 8. Dias VV, Brissos S, Frey BN, et al. Insight, quality of life and cognitive functioning in euthymic patients with bipolar disorder. J. Affect. Disord. 2008;110(1-2):75-83.
- 9. Margariti M, Ploumpidis D, Economou M, et al. Quality of life in schizophrenia spectrum disorders: associations with insight and psychopathology. Psychiatry Res. 2015;225(3):695-701.
- 10. Altun ÖŞ, Karakaş SA, Olçun Z, et al. An investigation of the relationship between schizophrenic patients' strength of religious faith and adherence to treatment. Arch. Psychiatr. Nurs. 2018;32(1):62-65.
- 11. Yılmaz E, Okanlı A. The effect of internalized stigma on the adherence to treatment in patients with schizophrenia. Arch. Psychiatr. Nurs. 2015;29(5):297-301.
- 12. Sajatovic M, Chen P, Dines P, et al. Psychoeducational approaches to medication adherence in patients with bipolar disorder. Disease Management & Health Outcomes. 2007;15(3):181-192.
- 13. Krahn GL. WHO World Report on Disability: a review. Disabil Health J. 2011;4(3):141-142.
- 14. Karadağ F, Oral ET, Aran Yalçın F, et al. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Turk Psikiyatri Derg. 2001;13(2):107-114.
- 15. Guy W, ECDEU Assessment Manual for Psychopharmacology, Revised US Dept Health, Education and Welfare publication (ADM), Rockville, National Institude of Mental Health. 1976;76-338.
- 16. Aslan S, Kılıç BG, Karakılıç H, et al. İçgörünün üç bileşenini değerlendirme ölçeği: Güvenilirlik ve geçerlik çalışması. Türkiye’de Psikiyatri. 2001; 3(1):17-24.
- 17. Yılmaz S. Psikiyatri hastalarında ilaç yan etkileri ve ilaç uyumu. İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi 2004.
- 18. Brüggemann BR, Garlipp P, Haltenhof H, et al. Quality of life and social support as outcome characteristics of a psychiatric day hospital. Ger. J. Psychiatry. 2007;10(3):58-68.
- 19. Singh NK, Chakraborty P. A comparative study of perceived social support in schizophrenia and bipolar affective disorder (Manic) cases. Indian Journal of Health & Wellbeing. 2020;11(7-9):393-397.
- 20. Hülya K, Demir S. Şizofreni ve bipolar bozukluğu olan hastalarda içselleştirilmiş damgalanma, benlik saygısı ve algılanan sosyal destek. Cukurova Med. J. 2018;43(1):99-106.
- 21. Prabhakaran S, Nagarajan P, Varadharajan N, et al. Relationship Between Quality of Life and Social Support Among Patients with Schizophrenia and Bipolar Disorder: A Cross-Sectional Study. Journal of Psychosocial Rehabilitation and Mental Health. 2021:1-9.
- 22. Brunt D, Hansson L. The social networks of persons with severe mental illness in in-patient settings and supported community settings. J Ment Health. 2002;11(6):611-621.
- 23. Kazan Kizilkurt O, Giynas FE, Yazici Gulec M, et al. Bipolar disorder and perceived social support: relation with clinical course, and the role of suicidal behaviour. Psychiatr. Clin. Psychopharmacol. 2019;29(4):787-793.
- 24. Uygun E, Cebeci RB, Özsoy E, et al. Investigation of the relationship between perceived social support and psychological resilience in bipolar disorder: a cross-sectional study. Anadolu Psikiyatr. Derg. 2020; 21(1):37-44.
- 25. Sawant NS, Jethwani KS. Understanding family functioning and social support in unremitting schizophrenia: A study in India. Indian J. Psychiatry. 2010;52 (2):145.
- 26. Braw Y, Sitman R, Sela T, et al. Comparison of insight among schizophrenia and bipolar disorder patients in remission of affective and positive symptoms: analysis and critique. Eur. Psychiatry. 2012;27(8):612-618.
- 27. Staner L, Tracy A, Dramaix M, et al. Clinical and psychosocial predictors of recurrence in recovered bipolar and unipolar depressives: a one-year controlled prospective study. Psychiatry Res. 1997;69(1):39-51.
- 28. Gutiérrez-Rojas L, Martínez-Ortega JM, Pérez-Costillas L, et al. Illness insight and medication adherence among patients with bipolar disorder. J. Nerv. Ment. Dis. 2020;208(6):481-487.
- 29. Strauss JL, Johnson SL. Role of treatment alliance in the clinical management of bipolar disorder: stronger alliances prospectively predict fewer manic symptoms. Psychiatry Res. 2006;145(2-3):215-223.
- 30. Kulhara P, Basu D, Mattoo SK, et al. Lithium prophylaxis of recurrent bipolar affective disorder: long-term outcome and its psychosocial correlates. J. Affect. Disord. 1999;54(1-2):87-96.
- 31. El-Monshed A, Amr M. Association between perceived social support and recovery among patients with schizophrenia. Int. J. Africa Nurs. Sci. 2020;13:100236.
- 32. Hélène T, Hélène V, Jean B, et al. Impact of interpersonal factors on insight in schizophrenia. Schizophr. Res. 2014;159(2-3):527-532.
- 33. Baloush-Kleinman V, Levine SZ, Roe D, et al. Adherence to antipsychotic drug treatment in early-episode schizophrenia: a six-month naturalistic follow-up study. Schizophr. Res. 2011;130(1-3):176-181.
- 34. Mahmoud AS, Berma AE, Gabal SAAS. Relationship between social support and the quality of life among psychiatric patients. J. psychiatry psychiatr. disord. 2017;1(2):57-75.
- 35. Kumar V, Singh B, Singh P, et al. Expressed Emotion and Social Support in Rehospitalized Psychiatric Patients. Social Work. 2018;9(2).
Şizofreni ve Bipolar Bozukluk Tanılı Bireylerde Algılanan Sosyal Desteğin İçgörü Düzeyi ve Tedavi Uyumuyla İlişkisi
Abstract
Amaç: Bu çalışmada bipolar ve şizofreni tanılı hastaların algıladıkları sosyal desteğin tedavi uyumları ve içgörü düzeyleriyle ilişkisinin belirlenmesi amaçlanmıştır.
Araçlar ve Yöntem: Bu araştırma son 1 yıl içinde kliniğimizde yatarak tedavi görmüş, remisyon döneminde olan, 55 bipolar ve 55 şizofreni tanılı hasta olmak üzere 110 birey ile yürütülmüştür. Katılımcılara sosyodemografik ve klinik veri formu, Young Mani Derecelendirme Ölçeği (YMDÖ), Klinik Global İzlenim Ölçeği (CGİ), İçgörünün Üç bileşenini Değerlendirme Ölçeği (İÜBDÖ), Morisky Tedavi Uyum Ölçeği (MTUÖ) ve Çok Boyutlu Algılanan Sosyal Destek Ölçeği (ÇBASD) uygulanmıştır.
Bulgular: Bipolar hastaların yaş ortalaması 40.47±12.96, şizofreni tanılı hastaların yaş ortalaması 40.45±11.71 idi. Algılanan aile, arkadaş, özel biri desteği ve total destek puanı bipolar hastalarda anlamlı (p=0.000, p=0.000, p=0.004, p=0.000, sırasıyla) yüksek saptanmış olup, en yüksek destek aileden, ardından arkadaş ve önemli kişilerden algılanmıştır. Gruplar tedavi uyumları açısından farklılık (p=0.083) göstermemekle birlikte, iç görü puanı bipolar hastalarda anlamlı yüksekti (p=0.001). Gruplar algılanan sosyal desteği etkileyen faktörler açısından hiyerarşik regrasyon analiziyle değerlendirilmiştir. Cinsiyet, eğitim yılı, içgörü ve tedavi uyumunun sosyal destek için prediktif (p=0.04, p=0.01, p<0.001, p=0.01, sırasıyla) olduğu görülmüştür.
Sonuç: Bipolar ve şizofren hastalara bakım verenlerin (aile vb.) sosyal desteğin klinik gidişe etkisi konusunda bilgilendirilmesi içgörü ve tedavi uyumuna olumlu katkı sağlayarak bakım verenlerin yükünü azaltabilir.
Supporting Institution
yok.
References
- 1. Brissos S, Dias VV, Carita AI, et al. Quality of life in bipolar type I disorder and schizophrenia in remission: clinical and neurocognitive correlates. Psychiatry Res. 2008;160(1):55-62.
- 2. Eker D, Arkar H, Yaldız H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turkish Journal of Psychiatry. 2001;12(1):17-25.
- 3. Kleindienst N, Engel R, Greil W. Psychosocial and demographic factors associated with response to prophylactic lithium. A systematic review for bipolar disorders. Psychol. Med. 2005;35(12):1685-1694.
- 4. Cohen AN, Hammen C, Henry RM, et al. Effects of stress and social support on recurrence in bipolar disorder. J. Affect. Disord. 2004;82(1):143-147.
- 5. Corrigan PW, Phelan SM. Social support and recovery in people with serious mental illnesses. Community Ment. Health J. 2004;40(6):513-523.
- 6. Hendryx M, Green CA, Perrin NA. Social support, activities, and recovery from serious mental illness: STARS study findings. J. Behav. Health Serv. Res. 2009;36(3):320-329.
- 7. Reddy M. Insight and psychosis. Indian J. Psychol. Med. 2015;37(3):257-260.
- 8. Dias VV, Brissos S, Frey BN, et al. Insight, quality of life and cognitive functioning in euthymic patients with bipolar disorder. J. Affect. Disord. 2008;110(1-2):75-83.
- 9. Margariti M, Ploumpidis D, Economou M, et al. Quality of life in schizophrenia spectrum disorders: associations with insight and psychopathology. Psychiatry Res. 2015;225(3):695-701.
- 10. Altun ÖŞ, Karakaş SA, Olçun Z, et al. An investigation of the relationship between schizophrenic patients' strength of religious faith and adherence to treatment. Arch. Psychiatr. Nurs. 2018;32(1):62-65.
- 11. Yılmaz E, Okanlı A. The effect of internalized stigma on the adherence to treatment in patients with schizophrenia. Arch. Psychiatr. Nurs. 2015;29(5):297-301.
- 12. Sajatovic M, Chen P, Dines P, et al. Psychoeducational approaches to medication adherence in patients with bipolar disorder. Disease Management & Health Outcomes. 2007;15(3):181-192.
- 13. Krahn GL. WHO World Report on Disability: a review. Disabil Health J. 2011;4(3):141-142.
- 14. Karadağ F, Oral ET, Aran Yalçın F, et al. Young mani derecelendirme ölçeğinin Türkiye’de geçerlik ve güvenilirliği. Turk Psikiyatri Derg. 2001;13(2):107-114.
- 15. Guy W, ECDEU Assessment Manual for Psychopharmacology, Revised US Dept Health, Education and Welfare publication (ADM), Rockville, National Institude of Mental Health. 1976;76-338.
- 16. Aslan S, Kılıç BG, Karakılıç H, et al. İçgörünün üç bileşenini değerlendirme ölçeği: Güvenilirlik ve geçerlik çalışması. Türkiye’de Psikiyatri. 2001; 3(1):17-24.
- 17. Yılmaz S. Psikiyatri hastalarında ilaç yan etkileri ve ilaç uyumu. İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi 2004.
- 18. Brüggemann BR, Garlipp P, Haltenhof H, et al. Quality of life and social support as outcome characteristics of a psychiatric day hospital. Ger. J. Psychiatry. 2007;10(3):58-68.
- 19. Singh NK, Chakraborty P. A comparative study of perceived social support in schizophrenia and bipolar affective disorder (Manic) cases. Indian Journal of Health & Wellbeing. 2020;11(7-9):393-397.
- 20. Hülya K, Demir S. Şizofreni ve bipolar bozukluğu olan hastalarda içselleştirilmiş damgalanma, benlik saygısı ve algılanan sosyal destek. Cukurova Med. J. 2018;43(1):99-106.
- 21. Prabhakaran S, Nagarajan P, Varadharajan N, et al. Relationship Between Quality of Life and Social Support Among Patients with Schizophrenia and Bipolar Disorder: A Cross-Sectional Study. Journal of Psychosocial Rehabilitation and Mental Health. 2021:1-9.
- 22. Brunt D, Hansson L. The social networks of persons with severe mental illness in in-patient settings and supported community settings. J Ment Health. 2002;11(6):611-621.
- 23. Kazan Kizilkurt O, Giynas FE, Yazici Gulec M, et al. Bipolar disorder and perceived social support: relation with clinical course, and the role of suicidal behaviour. Psychiatr. Clin. Psychopharmacol. 2019;29(4):787-793.
- 24. Uygun E, Cebeci RB, Özsoy E, et al. Investigation of the relationship between perceived social support and psychological resilience in bipolar disorder: a cross-sectional study. Anadolu Psikiyatr. Derg. 2020; 21(1):37-44.
- 25. Sawant NS, Jethwani KS. Understanding family functioning and social support in unremitting schizophrenia: A study in India. Indian J. Psychiatry. 2010;52 (2):145.
- 26. Braw Y, Sitman R, Sela T, et al. Comparison of insight among schizophrenia and bipolar disorder patients in remission of affective and positive symptoms: analysis and critique. Eur. Psychiatry. 2012;27(8):612-618.
- 27. Staner L, Tracy A, Dramaix M, et al. Clinical and psychosocial predictors of recurrence in recovered bipolar and unipolar depressives: a one-year controlled prospective study. Psychiatry Res. 1997;69(1):39-51.
- 28. Gutiérrez-Rojas L, Martínez-Ortega JM, Pérez-Costillas L, et al. Illness insight and medication adherence among patients with bipolar disorder. J. Nerv. Ment. Dis. 2020;208(6):481-487.
- 29. Strauss JL, Johnson SL. Role of treatment alliance in the clinical management of bipolar disorder: stronger alliances prospectively predict fewer manic symptoms. Psychiatry Res. 2006;145(2-3):215-223.
- 30. Kulhara P, Basu D, Mattoo SK, et al. Lithium prophylaxis of recurrent bipolar affective disorder: long-term outcome and its psychosocial correlates. J. Affect. Disord. 1999;54(1-2):87-96.
- 31. El-Monshed A, Amr M. Association between perceived social support and recovery among patients with schizophrenia. Int. J. Africa Nurs. Sci. 2020;13:100236.
- 32. Hélène T, Hélène V, Jean B, et al. Impact of interpersonal factors on insight in schizophrenia. Schizophr. Res. 2014;159(2-3):527-532.
- 33. Baloush-Kleinman V, Levine SZ, Roe D, et al. Adherence to antipsychotic drug treatment in early-episode schizophrenia: a six-month naturalistic follow-up study. Schizophr. Res. 2011;130(1-3):176-181.
- 34. Mahmoud AS, Berma AE, Gabal SAAS. Relationship between social support and the quality of life among psychiatric patients. J. psychiatry psychiatr. disord. 2017;1(2):57-75.
- 35. Kumar V, Singh B, Singh P, et al. Expressed Emotion and Social Support in Rehospitalized Psychiatric Patients. Social Work. 2018;9(2).
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Original Articles |
| Authors | |
| Early Pub Date | April 5, 2024 |
| Publication Date | April 29, 2024 |
| Published in Issue | Year 2024 Volume: 8 Issue: 1 |
Cite
Ahi Evran Medical Journal is indexed in ULAKBIM TR Index, Turkish Medline, DOAJ, Index Copernicus, EBSCO and Turkey Citation Index. Ahi Evran Medical Journal is periodical scientific publication. Can not be cited without reference. Responsibility of the articles belong to the authors.
