The relationship between social cognition, self-efficacy, social adjustment and treatment compliance in euthymic patients with bipolar disorder

Objective: Treatment compliance and current social adjustment are the factors that determine disease course and quality of life in euthymic patients with bipolar disorder. It is known that self-efficacy, social cognitive functioning and premorbid social adjustment influence treatment compliance and current social adjustment. This study aimed to investigate the relationship between social cognitive functioning, self-efficacy, premorbid adjustment, current social adjustment and treatment compliance in euthymic patients with bipolar disorder. Method: 54 patients with bipolar disorder who were euthymic for at least three months and 56 healthy controls were participants of this study. All participants were assessed with Reading the Mind in the Eyes Test, Hinting Task both of which measure social cognitive functioning, General Self-Efficacy Scale and the Social Adaptation Self-evaluation Scale. The patient group was also given Premorbid Adjustment Scale and 4-Item Morisky Medication Adherence Scale. Results: Social cognitive functions and self-efficacy were found to be significantly lower in patient group than healthy controls. Social cognitive performance and self-efficacy, social cognitive performance and current social adjustment were positively correlated in healthy contols but not in patient group. While there was no relationship between premorbid adjustment and self-efficacy, those who had lower premorbid adjustment had lower levels of current social adjustment. In both groups, self-efficacy and current social adjustment were positively correlated. There was no relationship between self-efficacy and treatment complience, duration of euthymia and treatment compliance; duration of euthymia and current social adjustment. Conclusion: While the relationship between social cognitive functions and self-efficacy; social cognitive functions and social adjustment were positively correlated in healthy contols, there was no significant correlation between these parameters in patient group. The reason for this might be the disruptive effect of bipolar disorder itself; neurocognitive impairement caused by bipolar disorder and by medication use on social cognitive functions. The relationship between premorbid adjustment and current social adjustement shows that premorbid adjustment might be a predictor of bipolar disorder. Treatment compliance and duration of euthymia were not correlated with other variables of this study. The reason for this might be sample selection bias caused by choosing patients with long duration of euthymia; therefore, better current social adjustment and treatment compliance than usual patient sample. Key Words: Bipolar Disorder, Self-Efficacy, Social Cognition, Social Adjustment, Treatment Compliance