Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neuropsychiatry

Background: Bipolar mood disorders are chronic and recurrent diseases associated with a deterioration ofsocial, work-related performance, and a reduction of leisure activities. There is an increased interest in the low functioning and disabilities in euthymic bipolar subjects, impacted by clinical variables, and neuro-cognitive impairments. The present study aims to identify social functioning in euthymic bipolar I individuals and the relevant influences of its confounders.Methods: This is a case-control,comparative study of 40 bipolar-I [DSM IV] euthymic adults of HAM-D < 7, and YMRS <6, for at least the last prior month,compared with 40 normal controls. They filled inquestionnaires on the Pre-morbid Social Adjustment Scale(PAS)and Social Functioning Scale(SFS).Wechsler Adult Intelligence sub-Scales(WAIS) were alsoadministered for possible existing cognitive impairments. Results:Premorbidly, Euthymic subjects scored worse on PAS than controls, both as an overall score and individual items of sociability/ withdrawal, peer relationships, and employment /schooling.SFS application to euthymics revealed some significant impairments compared to controls in different areas as ;social engagements,leisure time and recreation ,occupation / employment , independence related to performances ,prosocial activities, and the overall score. As an indicator for short-term working {u2013}auditory memory, digit span was the more disrupted item of cognition tested by WAIS on the euthymic persons, than controls.Euthymics having familial antecedentswith BMD,predominant manic polarity, psychotic features, comorbid substance abuse, lower subjective satisfaction,perceived cognitive deficits,and nopsychotherapeutic/rehabilitative interventions but not the illness severitywere correlated with poor social functioning,same as premorbid maladaptation and below average performance on WAIS- digit span subscale. Conclusion: Social functioning impact, and subsyndromal recovery of euthymic BMD subjects are confirmed,encouraging useof adjunctive psychological and rehabilitativeinterventions to further limit morbidities and disabilities and improve symptomatic and social functioning outcomes, within the biopsychosocial approach

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