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Title: Associations between family cohesion, adaptability, and functioning of patients with bipolar disorder with clinical syndromes in hebei, China
Authors: Zhang, XJ
Zhao, MK
Li, J
Shi, L
Xu, XF
Dai, Q
Zhang, YH
Liu, HL
Liu, W
Zhang, XY
Li, KQ
Shi, ZB
Lin, CY 
Issue Date: 2019
Source: Journal of international medical research, 2019, v. 47, no. 12, p. 6004-6015
Abstract: Objective We aimed to investigate the symptoms of inpatients with bipolar disorder (BD) in different types of families, and to explore the correlations between family coherence, family adaptability, and family functioning among inpatients with BD.
Methods Inpatients with BD in Hebei, China (n = 61; mean age = 33.85 +/- 10.54; 39 males) participated in this study. Participants' symptoms were evaluated using the Bech-Rafaelsen Mania Scale (BRMS) and Hamilton Depression Rating Scale (HDRS) at weeks 1, 4, and 8 after their admission to the hospital. Participants' family type was assessed using the Family Adaptability and Cohesion Scale II-Chinese Version. Family functioning was assessed using Family Assessment Device.
Results Participants were classified into three family types: balanced (n = 13), mid-range (n = 28), and extreme (n = 20). BRMS scores improved over time in patients from all three family types. Improvement was slightly better with the balanced than the extreme family type. HDRS scores showed an improving trend over time, although this was not significant. Family coherence, adaptability, and functioning were mutually correlated.
Conclusion The family system and family functioning are important factors that clinicians should keep in mind when treating people with BD.
Keywords: Bipolar
Mental health
Publisher: SAGE Publications
Journal: Journal of international medical research 
ISSN: 0300-0605
EISSN: 1473-2300
DOI: 10.1177/0300060519877030
Rights: © The Author(s) 2019
Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (
The following publication Zhang, X. J., Zhao, M. K., Li, J., Shi, L., Xu, X. F., Dai, Q., . . . Lin, C. Y. (2019). Associations between family cohesion, adaptability, and functioning of patients with bipolar disorder with clinical syndromes in hebei, China. Journal of International Medical Research, 47(12), 6004-6015 is available at
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