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Monday, November 2, 2009: 3:30 PM
Learning Objective 1: The learner will be able to explain the biopsychosocial model of the onset, course and expression of bipolar disorder.
Learning Objective 2: The learner will be able to categorize clinical meaningful profiles of family functioning as perceived by adults with bipolar disorder
Introduction: According to the World Federation for Mental Health, Bipolar Disorder (BD) affects an estimated 27 million people worldwide and it is the sixth leading cause of disability in terms of lost years of healthy life in the developed world. .Results from a new global survey conducted in Australia, Canada, Germany , Italy , Mexico , New Zealand, Spain , Sweden , UK and the USA indicates that patients and professional treatment providers face significant challenges in managing BD. Among these challenges is the management of environmental influences that affect course and outcome; these include marital distress, stressful life events and family functioning. Regarding family function, researchers have focused primarily on two aspects: (1) the nature and impact of criticism and expressed emotion in the home environment, and (2) the impact of perceived social support from family members. This study aimed to identify clinically meaningful profiles of family functioning as perceived by adults with BD.
Methods: A bio-psychosocial model of the course of BPD provided the conceptual framework for the current study. We recruited 116 outpatients who attended a Community Mental Health Center (CMHC) in midwestUSA ; they were participating in a randomized clinical trial of a psychosocial intervention and they reported living with their family. Patients completed the self-report Family Assessment Device (FAD), which defines multiple dimensions of family structure, organization and transactional patterns. Hierarchical cluster analysis of data, based on six FAD subscales, was used to identify profiles of family functioning.
Results: Two profiles defined 60% of our sample; these profiles could be characterized as “healthy family” profiles in all six dimensions of family function. A third profile defined 40% of the sample; this profile could be characterized as an “unhealthy family” profile in all six dimensions of family function.
Discussion: Clinicians need to systematically assess the structural, organizational and transactional dimensions of families of their patients with BD who reside with their families. Depending on patient preference, this assessment could be done alone or with the family members; sometime family members are unavailable or unwilling to participate. Data from these assessments lend information to understanding what patients are experiencing and define areas for individual, group and family interventions directed at improving both patient and family outcomes.
Methods: A bio-psychosocial model of the course of BPD provided the conceptual framework for the current study. We recruited 116 outpatients who attended a Community Mental Health Center (CMHC) in midwest
Results: Two profiles defined 60% of our sample; these profiles could be characterized as “healthy family” profiles in all six dimensions of family function. A third profile defined 40% of the sample; this profile could be characterized as an “unhealthy family” profile in all six dimensions of family function.
Discussion: Clinicians need to systematically assess the structural, organizational and transactional dimensions of families of their patients with BD who reside with their families. Depending on patient preference, this assessment could be done alone or with the family members; sometime family members are unavailable or unwilling to participate. Data from these assessments lend information to understanding what patients are experiencing and define areas for individual, group and family interventions directed at improving both patient and family outcomes.