Social competence and observer-rated social functioning in bipolar disorder.
Social competence and observer-rated social functioning in bipolar disorder.
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DOI：
10.1111/j.1399-5618.2010.00880.x
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发表时间：
2010-12
影响因子：
5.4
通讯作者：
Patterson TL
中科院分区：
文献类型：
--
作者：
Depp CA;Mausbach BT;Harvey PD;Bowie CR;Wolyniec PS;Thornquist MH;Luke JR;McGrath JA;Pulver AE;Patterson TL
社会功能障碍似乎是常见的双相情感障碍，虽然估计已主要来自自我报告的措施。我们检查了基于表现和基于行为的社交能力和功能评级，并评估了双相情感障碍患者的症状和神经认知能力对社交功能的贡献。在这项横断面研究中，164名双相情感障碍患者接受了基于表现的社会技能表现评估（SSPA），由一名知情人对特定功能水平（SLOF）-人际关系子量表进行评分，接受抑郁和躁狂症状的临床评分，并进行神经认知测试。我们评估了表现出社交缺陷的患者比例，并检查了神经认知能力、抑郁和躁狂症状的综合指标与SSPA评分之间的相关性。样本的平均年龄为47.6岁（SD = 14.1）。受试者平均有轻度抑郁和轻微躁狂症状。共有29%的人表现出正常参考的损害SSPA，和64%的注册至少有一个SLOF项目的损害;失业的主题有较低的SSPA和SLOF评级。神经认知表现与基于表现的社会功能和非基于表现的社会功能相关，而抑郁和躁狂症状仅与非基于表现的社会功能障碍相关。在多变量模型中，抑郁症是与社会功能和社会能力受损（即，能力）增加了抑郁症与神经认知障碍和社会功能之间关系的强度（即，现实世界的功能）。我们的研究证实了双相抑郁症与社会功能的负相关。一个亚组的门诊双相情感障碍患者有受损的社会能力，这，当存在时，恶化抑郁症和认知障碍对社会功能的影响。
Impairment in social functioning appears to be common in bipolar disorder, although estimates have been derived largely from self-report measures. We examined performance-based and observer-based ratings of social competence and functioning and assessed the contribution of symptoms and neurocognitive ability to social functioning in bipolar disorder. In this cross-sectional study, 164 subjects with bipolar disorder were administered the performance-based Social Skills Performance Assessment (SSPA), rated by an informant on the Specific Level of Functioning (SLOF)–Interpersonal subscale, received clinical ratings of depression and manic symptoms, and performed neurocognitive tests. We assessed the proportion of patients exhibiting social deficits and examined the associations between composite measures of neurocognitive ability, depression and manic symptoms, and SSPA scores with informant-rated, real-world social functioning. Mean age of the sample was 47.6 years (SD = 14.1). Subjects were experiencing, on average, mild levels of depression and minimal manic symptoms. A total of 29% exhibited norm-referenced impairment on the SSPA, and 64% registered at least one impairment on SLOF items; unemployed subjects had lower SSPA and SLOF ratings. Neurocognitive performance correlated with both performance-based and observer-rated social functioning, whereas depressive and manic symptoms correlated only with observer-rated social impairments. In multivariate models, depression was the most potent association with social functioning, and impairment in social competence (i.e., capacity) increased the strength of the relationships between depression and neurocognitive impairment and social functioning (i.e., real-world functioning). Our study confirmed the negative relationship of bipolar depression with social functioning. A subgroup of outpatients with bipolar disorder has impaired social competence, which, when present, worsened the impact of depression and cognitive impairment on social functioning.
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