Abstract / Summary
Depression is a major contributor to the burden of bipolar disorder (BD). Psychosocial factors are known to be important to overall wellbeing in severe mental illnesses, but their longitudinal association with depressive symptom severity in BD specifically remains understudied. Social support is one such potentially modifiable factor; however, its role in BD — and whether its effects differ by sex — is not well established. The present report included 117 patients with BD (50% female), that were followed approximately bi-annually for up to nine timepoints over 4.5 years. Baseline social support was assessed using two items from the World Health Organization (WHOQOL)-BREF, capturing relationship satisfaction and friend support. Depressive severity was assessed over time using the Hamilton Depression Rating Scale (HAMD). Generalized Estimating Equation (GEE) models were used to assess whether baseline social support was associated with long term depressive severity and whether this differed by sex, controlling for baseline depressive severity, age and time. We observed a significant, negative main effect of baseline friend support on long-term depressive symptom severity, controlling for baseline depressive severity, age and time. When examining the sexes separately, we observed a significant negative effect of baseline friend support in males (but not in females) on depressive symptom severity (controlling for baseline depressive severity), where higher baseline friend support was associated with lower depressive severity long-term. These findings provide preliminary evidence that friend support may be an important modifiable risk factor in BD. This finding should be replicated in larger samples. Friend support may be an important buffer against depressive symptoms, particularly in male patients with BD.