Affective lability and social functioning in severe mental disorders

Margrethe Collier Høegh,Sofie R Aminoff,Trine Vik Lagerberg,Torill Ueland,Stine Holmstul Olsen,Synve Hoffart Lunding,Ingrid Melle

doi:10.1007/s00406-022-01380-1

Margrethe Collier Høegh, Sofie R Aminoff + Show 5 more

Open Access

https://doi.org/10.1007/s00406-022-01380-1

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Abstract

Social functioning is impaired in severe mental disorders despite clinical remission, illustrating the need to identify other mechanisms that hinder psychosocial recovery. Affective lability is elevated and associated with an increased clinical burden in psychosis spectrum disorders. We aimed to investigate putative associations between affective lability and social functioning in 293 participants with severe mental disorders (schizophrenia- and bipolar spectrum), and if such an association was independent of well-established predictors of social impairments. The Affective Lability Scale (ALS-SF) was used to measure affective lability covering the dimensions of anxiety-depression, depression-elation and anger. The interpersonal domain of the Social Functioning Scale (SFS) was used to measure social functioning. Correlation analyses were conducted to investigate associations between affective lability and social functioning, followed by a hierarchical multiple regression and follow-up analyses in diagnostic subgroups. Features related to premorbid and clinical characteristics were entered as independent variables together with the ALS-SF scores. We found that higher scores on all ALS-SF subdimensions were significantly associated with lower social functioning (p < 0.005) in the total sample. For the anxiety-depression dimension of the ALS-SF, this association persisted after controlling for potential confounders such as premorbid social functioning, duration of untreated illness and current symptoms (p = 0.019). Our results indicate that elevated affective lability may have a negative impact on social functioning in severe mental disorders, which warrants further investigation. Clinically, it might be fruitful to target affective lability in severe mental disorders to improve psychosocial outcomes.

Highlights

Social functioning, defined as the capacity of a person to function in different societal roles such as homemaker, worker, student, partner, family member or friend [1, 2], is an important marker of recovery and a predictor of quality of life in severe mental disorders [3, 4]
In a sample partially overlapping with that of the current study, we have previously found that affective lability is elevated in schizophrenia- and bipolar spectrum disorders compared to healthy controls [21]; with the highest level in bipolar II disorder (BDII) and high levels in schizophrenia and bipolar I disorder (BDI) [22]
Correlation coefficients are low to moderate, the analyses revealed significant associations between all of the Affective lability Scale Short Form (ALS-SF) subdimension scores and the Social Functioning Scale (SFS) interpersonal score, as well as the total score (p < 0.001)

Summary

Introduction

Social functioning, defined as the capacity of a person to function in different societal roles such as homemaker, worker, student, partner, family member or friend [1, 2], is an important marker of recovery and a predictor of quality of life in severe mental disorders [3, 4]. As social impairment is higher in schizophrenia compared to schizoaffective- and bipolar disorders [23], the presence and/ or prominence of psychotic symptoms may be of relevance. There are several other shared risk factors for social impairments highlighted in the literature These include male sex [34, 35], poor premorbid social functioning [36, 37], neurocognitive deficits [25, 38], total number of illness episodes [28, 39], duration of untreated illness [40, 41], negative symptoms including apathy [23, 33, 42] and comorbidity such as substance use and anxiety [28, 43,44,45,46]

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