Marital adjustment and family functioning in bipolar disorder type I in comparison with rheumatoid arthritis

Abstract

Objective: Marriage is known to affect health and functioning. Beside the importance of the marital status, le vels of marital adjustment and family functioning are found to have greater impact on health. Chronic di seases could have negative effects on marital adjustment and family functioning. Our aim in this study was to compare marital adjustment and family functioning between bipolar disorder (BD) type I and RA patients and their spouses. Method: Study sample included 49 BD type I and 48 RA patients and their spouses. BD patients were evaluated by the Structured Clinical Interview for DSM-IV Axis I Disorders, the Hamilton Rating Scale for Depression, and the Young Mania Rating BD patients in remission state and RA patients in chronic state were included, patients in acute state were excluded. The patients with RA and their spouses and the spouses of the BD patients were evaluated fort he detection of comorbid psychiatric disorders and the individuals who had any psychiatric disorder were excluded from the study. Marital adjustment and family functioning were assessed by using the Berksun-Soylemez-Kavacýk Marital Adjustment and Family Functioning Scale. The scale has three subscales; 1.family functioning and adjustment, 2.trust-loyalty-violence, and 3.marital dysphoria. Higher scores are interpreted as worse adjustment and functioning.Results: BD-I patients had higher total marital adjustment and family functioning scores compared to the RA patients (p = 0.004). Spouses of BDI patients had also higher scores than the spouses of RA patients (p = 0.001). When the scale is compared between the spouses, RA patients and their partners had similar scores. BD-I patients' partners had worse scores than the BD-I patients. Conclusion: BD-I even in remission state disrupts marital adjustment and family functioning more than a disease presenting with chronic pain. This result must be considered in treatment of the BD patients. It should be kept in mind that the spouses of BD patients are more dissatisfied with their marriages than the BD patients. Especially, adjustment of the spouse to the marriage is important.