Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0140
Trends in Psychiatry and Psychotherapy
Original Article

Differences in coping strategies in adult patients with bipolar disorder and their first-degree relatives in comparison to healthy controls

Diferenças entre as estratégias de coping em pacientes adultos com transtorno bipolar e seus familiares em comparação com controles saudáveis

Kelen Patrícia Bürke Bridi; Ana Claudia M. Loredo-Souza; Adam Fijtman; Mirela Vasconcelos Moreno; Márcia Kauer-Sant'Anna; Keila Maria Mendes Ceresér; Mauricio Kunz

http://dx.doi.org/10.1590/2237-6089-2017-0140 Trends Psychiatry Psychother, vol.40, n4, p.318-325, 2018
PDF
SciELO
Downloads: 0
Views: 292

Abstract

Abstract Introduction: The objective of this study was to compare patients with bipolar disorder (BD), their first-degree relatives and a group of healthy controls in terms of use of adaptive and maladaptive coping strategies, exploring differences between specific types of strategies and their correlations with clinical variables. Methods: This was a cross-sectional study enrolling 36 euthymic patients with BD, 39 of their first-degree relatives and 44 controls. Coping strategies were assessed using the Brief COPE scale. Results: Significant differences were detected in the use of adaptive and maladaptive strategies by patients, their first-degree relatives and controls. Patients used adaptive strategies less often than the patients’ relatives (p<0.001) and controls (p = 0.003). There was no significant difference between first-degree relatives and controls (p=0.707). In contrast, patients (p<0.001) and their relatives (p=0.004) both exhibited higher scores for maladaptive coping than controls. There was no significant difference regarding the use of maladaptive strategies between patients and their relatives (p=0.517). Conclusions: First-degree relatives were at an intermediate level between patients with BD and controls regarding the use of coping skills. This finding supports the development of psychosocial interventions to encourage use of adaptive strategies rather than maladaptive strategies in this population.

Keywords

Coping, Brief COPE, bipolar disorder, first-degree relatives

Resumo

Resumo Introdução: O objetivo deste estudo foi comparar os pacientes com transtorno bipolar (TB), seus familiares de primeiro grau e um grupo de controles saudáveis em termos de uso de estratégias adaptativas e não adaptativas, explorando diferenças entre tipos específicos de estratégias e suas correlações com variáveis clínicas. Métodos: Estudo transversal, envolvendo 36 pacientes com TB eutímicos, 39 familiares de primeiro grau e 44 controles. As estratégias de enfrentamento foram avaliadas usando a escala Brief COPE. Resultados: Foram detectadas diferenças significativas no uso de estratégias adaptativas e não adaptativas por pacientes, seus familiares e controles. Os pacientes usaram estratégias adaptativas com menos frequência do que os familiares (p<0,001) e controles (p=0,003). Não houve diferença significativa entre familiares dos pacientes e controles (p=0,707). Por outro lado, os pacientes (p<0,001) e seus familiares (p=0,004) exibiram pontuações mais elevadas para coping não adaptativo em relação aos controles. Não houve diferença significativa quando os pacientes foram comparados com seus familiares (p=0,517). Conclusões: Familiares de primeiro grau estavam em um nível intermediário entre pacientes com TB e controles no que diz respeito ao uso de habilidades de enfrentamento. Esta descoberta apoia o desenvolvimento de intervenções psicossociais para incentivar o uso de estratégias adaptativas em vez de estratégias inadequadas nessa população.

Palavras-chave

Coping, Brief COPE, transtorno bipolar, familiares de primeiro grau

References

Miklowitz DJ, Johnson SL. Social and familial factors in the course of bipolar disorder: basic processes and relevant interventions. Clin Psychol. 2009;16:281-96.

Lolich M, Vazquez GH, Alvarez LM, Tamayo JM. Psychosocial interventions in bipolar disorder: a review. Actas Esp Psiquiatr. 2012;40:84-92.

Sanchez-Moreno J, Martinez-Aran A, Tabarés-Seisdedos R, Torrent C, Vieta E, Ayuso-Mateos JL. Functioning and disability in bipolar disorder: an extensive review. Psychother Psychosom. 2009;78:285-97.

Lafer B, Soares J, Sanches M, Del Porto J. Transtorno bipolar: da genética à reabilitação psicossocial. Rev Bras Psiquiatr. 2004;26:1-2.

Malkoff-Schwartz SE, Anderson B, Sherrill JT, Siegel L, Patterson D, Kupfer DJ. Stressful life events and social rhythm disruption in the onset of manic and depressive bipolar episodes. Arc Gen Psychiatry. 1998;55:702-7.

Lazarus RS, Folkman S. Stress appraisal and coping. 1984.

Boschi S, Adams RE, Bromet EJ, Lavelle JE, Everett E, Galambos N. Coping with psychotic symptoms in the early phases of schizophrenia. Am J Orthopsychiatry. 2000;70:242-52.

Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. J Abnormal Psychol. 2000;109:504-11.

Greenhouse WJ, Meyer B, Johnson SL. Coping and medication adherence in bipolar disorder. J Affect Disord. 2000;59:237-41.

Christensen MV, Kessing LV. Clinical use of coping in affective disorder, a critical review of the literature. Clin Pract Epidemiol Ment Health. 2005;1:20-8.

Lam D, Wong G, Sham P. Prodromes, coping strategies and course of illness in bipolar affective disorder - a naturalistic study. Psychol Med. 2001;31:1397-402.

Grassi-Oliveira R, Daruy-Filho L, Brietzke E. New perspectives on coping in bipolar disorder. PsycholNeurosci. 2010;3:161-5.

Fletcher K, Parker GB, Manicavasagar V. Coping profiles in bipolar disorder. Compr Psychiatry. 2013;54:1177-84.

Goossens PJ, Knoppert-van der Klein EA, van Achterberg T. Coping styles of outpatients with a bipolar disorder. Arch Psychiatr Nurs. 2008;22:245-53.

Green MJ, Lino BJ, Hwang EJ, Sparks A, James C, Mitchell PB. Cognitive regulation of emotion in bipolar I disorder and unaffected biological relatives. Acta Psychiatr Scand. 2011;124:307-16.

Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, Eshleman S. Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry. 1994;51:8-19.

Chadda RK, Singh TB, Ganguly KK. Caregiver burden and coping: A prospective study of relationship between burden and coping in caregivers of patients with schizophrenia and bipolar affective disorder. Soc Psychiatry Psychiatr Epidemiol. 2007;42:923-30.

Heru AM, Ryan CE. Burden, reward and family functioning of caregivers for relatives with mood disorders: 1-year follow-up. J Affect Disord. 2004;83:221-5.

Ogilvie AD, Morant M, Goodwin GM. The burden on informal caregivers of people with bipolar disorder. Bipolar Disord. 2005;7(Suppl 1):25-32.

Stern M, Zevon MA. Stress, coping, and family environment: the adolescent's response to naturally occurring stressors. J Adolescent Res. 1990;5:290-305.

Nijjar R, Ellenbogen MA, Hodgins S. Personality, coping, risky behavior, and mental disorders in the offspring of parents with bipolar disorder: A comprehensive psychosocial assessment. J Affect Disord. 2014;166:315-23.

Parikh SV, Velyvis V, Yatham L, Beaulieu S, Cervantes P, Macqueen G. Coping styles in prodromes of bipolar mania. Bipolar Disord. 2007;9:589-95.

Carver CS, Scheier MF. Attention and self-regulation: A control-theory approach to human behavior. 1981.

Ribeiro J, Rodrigues A. Questões acerca do coping: A propósito do estudo de adaptação do Brief COPE. Psicol Saude Doenças. 2004;5:3-15.

Carver C, Scheier M, Weintraub J. Assessing coping strategies: A theoretically based approach. J Pers Soc Psychol.. 1989;6:267-83.

Carver CS. You want to measure coping but your protocol's too long: consider the Brief COPE. Int J Behav Med. 1997;4:92-100.

Meyer B. Coping with severe mental illness: relations of the Brief COPE with symptoms, functioning, and well-being. J Psychopathol Behav Assess. 2001;4:265-77.

Greenhouse WJ, Meyer B, Johnson SL. Coping and medication adherence in bipolar disorder. J Affect Disord. 2000;59:237-41.

Nitzburg GC, Russo M, Cuesta-Diaz A, Ospina L, Shanahan M, Perez-Rodriguez M. Coping strategies and real-world functioning in bipolar disorder. J Affect Disord. 2016;198:185-8.

Jones SH, Bentall RP. A review of potential cognitive and environmental risk markers in the children of bipolar parents. Clin Psychol Rev. 2008;28:1083-95.

Kapczinski F, Vieta E, Andreazza AC, Frey BN, Gomes FA, Tramontina J. Allostatic load in bipolar disorder: implications for pathophysiology and treatment. Neurosci Biobehav Rev. 2008;32:675-92.

Miklowitz D, Otto M. Psychosocial interventions for bipolar disorder: A review of literature and introduction of the systematic treatment enhancement program. Psychopharmacol Bull. 2007;40:116-31.

Reinares M, Colom F, Sánchez-Moreno J, Torrent C, Martínez-Arán A, Comes M. Impact of caregiver group psychoeducation on the course and outcome of bipolar patients in remission: A randomized controlled trial. Bipolar Disord. 2008;10:511-9.

Folkman S, Lazarus RS. If it changes it must be a process: A study of emotion and coping during three stages of a college examination. J Pers Soc Psychol. 1985;48:150-70.

Folkman S, Lazarus RL, Dunkel-Schetter C, DeLongis A, Gruen R. Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. J Pers Soc Psychol. 1986;50:992-1003.

6169c5b9a9539550cc2b24a4 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections