Coping strategies of Bipolar patients’ relatives: a narrative review

The caregiving experience of a person with bipolar disorder is often characterized by feelings of powerless, hopelessness, and inability to change the situation. Relatives of patients with bipolar disorders have an extreme need to be supported in managing their family member’s illness and to learn adaptive strategies to cope with the situation. In fact, they often report high levels of subjective and objective burden, restrictions in social life, a high risk to develop depressive or anxiety symptoms, financial and working difficulties, general global health problems, and a reduced quality of life. Relatives develop different strategies to deal with patients’ symptoms and behaviours, which are defined “coping strategies”. A significant association between relatives’ coping strategies and the long-term outcome of BD patients has been found. The present paper aims to review available evidences on 1) coping strategies of relatives of patients with BD; 2) the efficacy of psychosocial interventions in the improvement of coping strategies of patients with BD. Papers’ search was carried out using Pubmed, Scopus and Embase databases. A structured data extraction tool was created, and a list of categories was then identified. Papers were included in one of the categories according to research aims. The three categories are: 1) coping strategies of relatives of patients with bipolar disorder; 2) coping strategies of children of patients with bipolar disorders; 2) efficacy of psychosocial intervention in improving relatives coping strategies. A total of 1365 papers were identified. By analyzing the abstract, 1334 papers were removed because they were either considered not relevant for the purpose of this review, or they were duplicates. The final list includes 14 papers. Moreover, maladaptive coping strategies, and especially emotion-focused coping strategies (i.e., avoidance and social isolation) have been identified as possible markers of bipolar illness in offspring of patients with BD. Finally, almost all studies assessing the efficacy of psychosocial interventions in improving relatives’ coping strategies, reported positive results. The findings of the present review highlight the importance to routinely provide PFI to patients and family members.