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Predictors of Patient and Caregiver Distress in an Adult Sample With Bipolar Disorder Seeking Family Treatment

Lee, Allison M. R. MD; Simeon, Daphne MD; Cohen, Lisa J. PhD; Samuel, Janine BA; Steele, Annie BA; Galynker, Igor I. MD, PhD

The Journal of Nervous and Mental Disease: January 2011 - Volume 199 - Issue 1 - p 18-24
doi: 10.1097/NMD.0b013e3182043b73
Original Articles

Little is known about the potentially unique sources of distress in populations seeking family-oriented treatment for bipolar disorder. The present study aimed to characterize this new treatment population by measuring depression, anxiety, quality of life, knowledge of bipolar disorder, therapeutic alliance, and mental illness stigma in 43 bipolar patients and 41 caregivers at family treatment intake. In all, 50% of patients and 27.6% of caregivers had significant depressive symptoms, whereas 51.2% of patients and 45.5% of caregivers had significant anxiety symptoms. Caregiver anxiety was inversely related to patient anxiety, stigma, and poor alliance. Treatment nonadherence was associated with more anxiety and stigma in patients and less anxiety in caregivers. In summary, family-oriented bipolar treatment seekers are significantly distressed at intake, and may benefit from lowering anxiety and stigma in patients and raising awareness and concern in caregivers. Future research should further clarify the complex relationships between caregiver and patient symptoms and attitudes.

Department of Psychiatry, Beth Israel Medical Center, New York, NY.

Supported by an ECRIP (Empire Clinical Research Investigator Program) Grant and by funding from the Zirinsky Mood Disorder Center and the Family Center for Bipolar Disorder.

Send reprint requests to Allison M. R. Lee, MD, Department of Psychiatry, Beth Israel Medical Center, 317 East 17th St. (Fierman Hall), 5th Floor, Room 13D, New York, NY 10003. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.