Background Social dysfunction is common among patients with bipolar disorder (BD) even during remission, underscoring the need to shift toward function-oriented treatment models. This study aimed to quantify the prevalence of social dysfunction in community-dwelling patients with BD and identify multidimensional biopsychosocial influencing factors. Methods A cross-sectional survey was conducted among 7,952 community-dwelling BD patients in Hangzhou. Social functioning was assessed using the Social Disability Screening Schedule (SDSS), with a score <InlineEquation ID="IEq1"> <EquationSource Format="TEX">\(\geq 2\)</EquationSource> </InlineEquation> indicating dysfunction. Multivariable logistic regression was performed to examine demographic, clinical, and psychosocial correlates. Results The prevalence of social dysfunction among community-dwelling patients with BD was 66.4%. Multivariable analysis identified several independent factors associated with this dysfunction, including divorced status (Adjusted Odds Ratio [AOR] <InlineEquation ID="IEq2"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.76, 95% Confidence Interval [CI]: 1.23–2.54), higher overall psychopathological severity (Clinician-Rated Dimensions of Psychosis Symptom Severity [CRDPSS] total score; AOR <InlineEquation ID="IEq3"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.56, 95% CI: 1.48–1.66),sleep insufficiency (AOR <InlineEquation ID="IEq4"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.79, 95% CI: 1.53–2.10), insufficient dietary status(AOR <InlineEquation ID="IEq5"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 2.00, 95% CI: 1.45–2.81),family history of psychiatric disorders (AOR <InlineEquation ID="IEq6"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.38, 95% CI: 1.02–1.88),comorbid physical illnesses (AOR <InlineEquation ID="IEq7"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.22, 95% CI: 1.09–1.37),adverse drug reactions (AOR <InlineEquation ID="IEq8"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.44, 95% CI: 1.20–1.74),psychiatric follow-up (AOR <InlineEquation ID="IEq9"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.36,95% CI:1.17–1.59) and illness stigma (AOR <InlineEquation ID="IEq10"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 1.17, 95% CI:1.03–1.32).Additionally, several factors were associated with decreased odds of social dysfunction,including younger age (18–34 years vs.<InlineEquation ID="IEq11"> <EquationSource Format="TEX">\(\geq 55\)</EquationSource> </InlineEquation> years, AOR <InlineEquation ID="IEq12"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 0.75, 95% CI: 0.58–0.97), being married (AOR <InlineEquation ID="IEq13"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 0.40, 95% CI: 0.32–0.50), retired status (AOR <InlineEquation ID="IEq14"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 0.62, 95% CI: 0.54–0.71), and high life satisfaction (AOR <InlineEquation ID="IEq15"> <EquationSource Format="TEX">\(=\)</EquationSource> </InlineEquation> 0.41, 95% CI: 0.24–0.67). Conclusion Social dysfunction is highly prevalent among community BD patients. Functional recovery efforts should focus on optimizing pharmacotherapy (to minimize side effects), targeting biological rhythms (sleep and nutrition), enhancing marital and psychosocial support, and improving life satisfaction. Clinical trial number Not applicable.

Prevalence and correlates of social dysfunction in community-dwelling patients with bipolar disorder: a cross-sectional study

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2026年1月19日

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LuLu Zhang,
Deyuan Wu,
Mingshan Ye,
Liting Wang,
Xiaohua Sun,
Mingjin Luo,
Haidong Song

摘要

Background

Social dysfunction is common among patients with bipolar disorder (BD) even during remission, underscoring the need to shift toward function-oriented treatment models. This study aimed to quantify the prevalence of social dysfunction in community-dwelling patients with BD and identify multidimensional biopsychosocial influencing factors.

Methods

A cross-sectional survey was conducted among 7,952 community-dwelling BD patients in Hangzhou. Social functioning was assessed using the Social Disability Screening Schedule (SDSS), with a score \(\geq 2\) indicating dysfunction. Multivariable logistic regression was performed to examine demographic, clinical, and psychosocial correlates.

Results

The prevalence of social dysfunction among community-dwelling patients with BD was 66.4%. Multivariable analysis identified several independent factors associated with this dysfunction, including divorced status (Adjusted Odds Ratio [AOR] \(=\) 1.76, 95% Confidence Interval [CI]: 1.23–2.54), higher overall psychopathological severity (Clinician-Rated Dimensions of Psychosis Symptom Severity [CRDPSS] total score; AOR \(=\) 1.56, 95% CI: 1.48–1.66),sleep insufficiency (AOR \(=\) 1.79, 95% CI: 1.53–2.10), insufficient dietary status(AOR \(=\) 2.00, 95% CI: 1.45–2.81),family history of psychiatric disorders (AOR \(=\) 1.38, 95% CI: 1.02–1.88),comorbid physical illnesses (AOR \(=\) 1.22, 95% CI: 1.09–1.37),adverse drug reactions (AOR \(=\) 1.44, 95% CI: 1.20–1.74),psychiatric follow-up (AOR \(=\) 1.36,95% CI:1.17–1.59) and illness stigma (AOR \(=\) 1.17, 95% CI:1.03–1.32).Additionally, several factors were associated with decreased odds of social dysfunction,including younger age (18–34 years vs. \(\geq 55\) years, AOR \(=\) 0.75, 95% CI: 0.58–0.97), being married (AOR \(=\) 0.40, 95% CI: 0.32–0.50), retired status (AOR \(=\) 0.62, 95% CI: 0.54–0.71), and high life satisfaction (AOR \(=\) 0.41, 95% CI: 0.24–0.67).

Conclusion

Social dysfunction is highly prevalent among community BD patients. Functional recovery efforts should focus on optimizing pharmacotherapy (to minimize side effects), targeting biological rhythms (sleep and nutrition), enhancing marital and psychosocial support, and improving life satisfaction.

Clinical trial number

Not applicable.