Social environment may influence mood stabiliser adherence

By Eleanor McDermid, Senior medwireNews Reporter

The attitudes of patients with bipolar disorder towards mood-stabilising medications are influenced by their social support system, say researchers.

The team found that more positive attitudes in patients were associated with them having a stronger perceived social support system and believing that they were in control of their own health.

“Knowing the importance of the social environment to medication attitudes, clinicians have the opportunity to themselves become an influential factor in how their patients think about [bipolar disorder] medication treatments”, say researchers Ching-Wen Chang (Case Western Reserve University, Cleveland, Ohio, USA) and co-workers.

For the study, a total of 122 bipolar disorder patients who had been taking a mood stabiliser for at least 6 months completed the Attitudes towards Mood Stabilizers Questionnaire (AMSQ). The researchers also assessed the patients’ demographic and clinical variables and found that, together, these explained 11% of the variability in AMSQ scores.

Adding patients’ scores on the Interpersonal Support Evaluation List (ISEL) and the External Health Locus of Control–Powerful Others (EHLC-PO) scale explained an additional 9% of the variability, making 20% in all.

Patients scored an average of 20.5 points on the EHLC-PO from a range of 6 to 36 points, with higher scores indicating greater perceived social support. They scored 70.8 points on the ISEL from a range of 0 to 120, with higher scores indicating a stronger belief that their health is under their own control, rather than being determined by people such as family and friends and healthcare professionals.

Results on these two scales inversely correlated with those on the AMSQ, indicating that patients’ positivity towards mood stabilisers rose with increasing perceived social support and a stronger feeling of being in control of their own health.

Chang et al conclude in Bipolar Disorders that their study “underscores the importance of the effect of social connectivity on health beliefs.”

However, they note that the influence of a patient’s social environment may also be affected by their current symptoms. “Working with patients and families to create a support system that can be increased during symptomatic episodes and decreased during euthymic episodes might promote self-management and capitalize on social connectedness”, they suggest.

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