Prevalence and correlates of social dysfunction in community-dwelling patients with bipolar disorder: a cross-sectional study

BACKGROUND: Social dysfunction is common among patients with bipolar disorder (BD) even during remission, underscoring the need to shift toward function-oriented treatment models. This study aimed to quantify the prevalence of social dysfunction in community-dwelling patients with BD and identify multidimensional biopsychosocial influencing factors. METHODS: A cross-sectional survey was conducted among 7,952 community-dwelling BD patients in Hangzhou. Social functioning was assessed using the Social Disability Screening Schedule (SDSS), with a score [Formula: see text] indicating dysfunction. Multivariable logistic regression was performed to examine demographic, clinical, and psychosocial correlates. RESULTS: The prevalence of social dysfunction among community-dwelling patients with BD was 66.4%. Multivariable analysis identified several independent factors associated with this dysfunction, including divorced status (Adjusted Odds Ratio [AOR] = 1.76, 95% Confidence Interval [CI]: 1.23–2.54), higher overall psychopathological severity (Clinician-Rated Dimensions of Psychosis Symptom Severity [CRDPSS] total score; AOR = 1.56, 95% CI: 1.48–1.66),sleep insufficiency (AOR = 1.79, 95% CI: 1.53–2.10), insufficient dietary status(AOR = 2.00, 95% CI: 1.45–2.81),family history of psychiatric disorders (AOR = 1.38, 95% CI: 1.02–1.88),comorbid physical illnesses (AOR = 1.22, 95% CI: 1.09–1.37),adverse drug reactions (AOR = 1.44, 95% CI: 1.20–1.74),psychiatric follow-up (AOR = 1.36,95% CI:1.17–1.59) and illness stigma (AOR = 1.17, 95% CI:1.03–1.32).Additionally, several factors were associated with decreased odds of social dysfunction,including younger age (18–34 years vs.[Formula: see text] years, AOR = 0.75, 95% CI: 0.58–0.97), being married (AOR = 0.40, 95% CI: 0.32–0.50), retired status (AOR = 0.62, 95% CI: 0.54–0.71), and high life satisfaction (AOR = 0.41, 95% CI: 0.24–0.67). CONCLUSION: Social dysfunction is highly prevalent among community BD patients. Functional recovery efforts should focus on optimizing pharmacotherapy (to minimize side effects), targeting biological rhythms (sleep and nutrition), enhancing marital and psychosocial support, and improving life satisfaction. CLINICAL TRIAL NUMBER: Not applicable.