Study on the association between affective symptoms and social dysfunction in patients with bipolar disorder based on network analysis

Objective To explore the correlations among depressive symptoms, manic symptoms, and social function deficits in patients with bipolar disorder (BD).

Methods A total of 452 BD patients were included in the study. The self-rating depression scale (SDS), Bech-Rafaelsen mania scale (BRMS), and social disability screening schedule (SDSS) were used to assess depressive symptoms, manic symptoms, and social function status respectively. An undirected network was used to estimate the network models of depressive symptom-social function deficiency and manic symptom-social function deficiency, and the central index and bridge central index were calculated. The network stability was further verified.

Results The average score of SDS in BD patients was (55.29±15.92), the BRMS score was 2.00 (0.00-6.00), and the SDSS score was 3.00 (1.00-9.00). In the depression-social dysfunction network model, extra-familial social activities (strength=1.56) were the central symptom, and marital function served as the main bridge symptom. In the manic-social dysfunction network model, extra-familial social activities (strength=1.46) were the central symptom, and occupation and work were the main bridge symptoms.

Conclusion Lack of social activities outside the family is a core manifestation of social dysfunction in patients with BD, while aspects such as marital function, occupation and work may serve as important intervention targets for improving patients' social functioning.