Association between pharmacological treatment adherence and family dynamics in patients with bipolar disorder: a cross-sectional correlational study

Bipolar disorder is a severe and chronic mental illness defined by extreme and debilitating shifts in mood, energy, and activity levels. The World Health Organization has recognized bipolar disorder as a leading cause of disability worldwide. The complex manifestations of the disorder present a profound challenge not only for patients but also for their families, impacting interpersonal relationships, occupational stability, and overall quality of life. In this cross-sectional, correlational study, 80 adults with DSM-5 bipolar disorder and one cohabiting family member each were recruited at an outpatient psychiatric clinic in Maracaibo, Venezuela (May–September 2024). Participants completed a validated 40-item Family Dynamics Scale and the WHOQOL-BREF. Adherence was assessed via a composite index of self-reported missed doses, prescription refill records, and family involvement. Statistical analysis involved descriptive statistics and the Pearson correlation coefficient to assess the relationship between treatment adherence and perceived family functioning. This study showed a strong, positive correlation (r = 0.82) between pharmacological treatment adherence and the perception of family functioning. The average adherence rate was 67.25%. Despite significant symptom severity, including episodes lasting over one week (100%) and severe psychotic symptoms (69%), patients reported a moderate-to-high quality of life (mean WHOQOL-BREF score: 78). Family support was a key factor, with 89% of patients reporting effective family involvement in their treatment management. High pharmacotherapy adherence correlates with healthier family dynamics. Integrating family-focused educational interventions into standard care could enhance adherence, stability, and quality of life, advocating for a family-centered treatment approach.