Indian Journal of Health and Well-being © 2020 Indian Association of Health, Research and Welfare

2020, 11(7-9), 393-397 ISSN-p-2229-5356,e-2321-3698

https://iahrw.org/our-services/journals/indian-journal-of-health-wellbeing/ NAAS Ratings 4.13

A comparative study of perceived social support in schizophrenia

and bipolar affective disorder (Manic) cases
Nand Kumar Singh1 and P. K. Chakraborty2
Psychiatric Social Work, Gwalior Mansik Arogyashala, Gwalior, Madhya Pradesh1
and RINPAS, Kanke, Ranchi, Jharkhand2

Perceived social support as the most persistently and powerfully associated with mental health. Increasing
perceived social support been shown to improve the well being of individual and affect the outcome of treatment in
schizophrenia and bipolar affective disorders (mania). The study aimed at investigating perceived social support in
people with schizophrenia and bipolar affective disorder (mania). The research work was done at the out patient
department of Ranchi Institute of Neuropsychiatry and Allied Sciences (RINPAS), Kanke, Ranchi, Jharkhand,
(India) in Schizophrenic and Bipolar Affective Disorder (Manic) cases. The sample consisting of 75 subjects each
diagnosed as schizophrenia and mania. The result indicate that schizophrenic group has less perceived social
support in comparison to manic group. Patient belongs to nuclear family perceived less support in both groups. The
present study focus that perceived social support of patient affect the etiology and management the mental disorders
like schizophrenia and mania.

Keywords: schizophrenia, bipolar affective disorders (mania), perceived social support

In recent years social support has emerged as an important variable
influencing and perhaps determining outcome in various disorders. It
is proposed and generally accepted that social support buttresses
against the deleterious of stress. In the context of better outcome of
schizophrenia and bipolar affective disorder in India and other
developing countries, consideration of social support as an
influential variable assumes importance. It is thought that social
support, available to the patients and caregivers because of joint and
extended family systems, minimizing the damaging effects of the
illness and thus improves outcomes.
The concept of social support has received increasing attention in
the psychiatric literature because deinstitutionalization of the
mentally ill has resulted in a large and increasing number of people
with schizophrenia and other serious mental disorders living in the
community (Buchanan, 1995).
The concept of social support has been used has been often
interchangeably with related term as “social bonds” (Handerson).
“Social Network” (Mueller, 1980). Although these concept are
hardly identical, they share a focus upon the relevance and
significance of human relationships.
Social support as “ information leading and individual to believe
that he is cared for loved as esteemed, and a number of network of
mutual obligation.”
Author Note
Dr. Nand Kumar Singh, Assistant Professor
1
Social support rise to prospective which emphasizes the
importance of an individuals cognitive appraisal of supportiveness,
that guide the individual's behavior and the evaluation of others
behavior in situation in which is needed. Thus, this perspective
centers around the “main effect model”. Social support especially
for schizophrenia in the community and family, has been the subject
of increasing in interest the past several years.
Perceived social support has been defined as an individual, s”
cognitive appraisal of being reliably connected to others” (Barrera,
1986) Further, the relation between perceived social support and
disorders does appear to result merely from the potential confounds
of prior symptomatology or social competence (Murell, 1986).
Thus, increasing perceived support in risk for psychological
disturbance may be an important preventive strategy,
Researchers suggested that perceived social support as the most
potential component of social support because of only to reason.
● That perceived social support as the most persistently and
powerfully associated with mental health.
● Other elements of support exert their by influencing this
perception focus attention on perceived social support as an
outcome. There are to general views raised to show the protective
benefits of perceived social support.
● Situation specific model in which perceived benefits of perceived
social support. Particularly stressful events or circumstances.
● Developmental perspective that views social support as an
important elements of social personality development.

Psychiatric Social Work, Gwalior Mansik Arogyashala Perceived social support is related to symptoms because when
Gwalior, Madhya Pradesh individuals are provided with supportive behaviour they cope
2
Dr. P. K. Chakraborty, Ex-Director along with stressful events more effectively and thus are less
RINPAS, Kanke, Ranchi, Jharkhand likely to experience psychological distress (Cohen & Will,
We have no known conflict of interest to disclose 1985).
Correspondence concerning this article should be addressed to In recent years social support has emerged as an important
Dr. Nand Kumar Singh, Assistant Professor, Psychiatric Social variable influencing and perhaps determining outcome in various
Work, Gwalior Mansik Arogyashala, Gwalior, Madhya Pradesh disorders. It is proposed and generally accepted that social support buttresses
E-mail: singh_nand74@yahoo.co.in against the deleterious of stress. In the context of better out com.
 SINGH AND CHAKRABORTY/ A COMPARATIVE STUDY OF PERCEIVED SOCIAL SUPPORT 394

Furthermore, social support itself may be partially predictable from
ongoing level of maladjustment since persisting it may affect long
term social competencies and habitual pattern of social interaction
(Hatfeld, 1978).
Method
Participants
The research work was done at the out patient department of Ranchi
Institute of Neuropsychiatry and Allied Sciences (RINPAS), Kanke,
Ranchi, Jharkhand, (India). The present study has two groups
(schizophrenia & Bipolar Affective Disorder (Manic) cases. The
sample consisting of 75 subjects each diagnosed as schizophrenia
and mania were included. The patients with either sex in the age
range of 21-45 years constituted the sample in both schizophrenia
and mania. Patient diagnosed of schizophrenia and mania according
to DCR of ICD-10 and patient who is co-operative to participated in
research work. Patient with at least 2nd episodes in last two years for
mania were included for the study. Patients with other (co-
morbid/organic/functional/Mental Retardation) and family history
of major physical and mental illness were also not included.
Instruments
Socio Demographic and Clinical Data Sheet: It is a semi structured
Performa especially designed for this study. It contains information
about socio demographic variables like age, sex, education, marital
status, religion, occupation and socio-economic status, domicile, etc.
Other than this following point will be included;- Diagnosis, history
of previous admission, history of treatment, age of onset, episode,
duration of present episode, family history of mental illness, any
history of significant head injury, seizure, mental retardation, etc.
Social Support Questionnaire: The scale has been developed by
Nehra, Kulhara, and Verma (1995). This scale measures perceived
social support i.e. social support perceived by the subject. It has total
18 items. The total score indicates the amount of perceived social
support. Higher score indicates more the amount of perceived social
support. Higher score indicates more perceived social support and
less score indicates less social support. The reliability and validity
has been seen. Test-Retest reliability after two weeks internal on 50
subjects was found to be 0.59**. Significant at 0.01 level.
Concurrent validity has been found to be significant at 0.01 level.
Statistical analysis
Data of present study is described using number, percentage, mean,
SD, chi square and t-test, Chi square was done between comparison
of socio-demographic variables of mania and schizophrenia. `Mean
and SD was done in both groups. t-test was done for the comparison
of perceived social support in schizophrenia and mania.
Procedure
The schizophrenic and manic patients has taken in study, who are
co-operative and met in the inclusion criteria. Socio-demographic
and clinical data sheet filed after interview of the patients and Social
Support Questionnaire was administered.
Results
The study sample consisted of total 150 patients. There were two

Table 1
Showing socio-demographic characteristics of manic and schizophrenic patients in age, sex,
martial status, education and domicile
Variables Mania Schizophrenia x2 df P Significance
N(%) N(%)
Age 0.1175 0.9429 NS
22(29.33) 23(30.66) df=2
21-30 43(57.33) 41(54.66)
31-40 10(13.33) 11(14.66)
41-45 75(100%) 75(100%)
Sex 0.1472 0.7012 NS
Male 50(66.66) 48(64.00) df=1
Female 25(33.33) 27(36.00)
75 75
Marital Status 0.2763 0.5991 NS
Married 43 (57.33) 46 (61.33) df=1
Unmarried 32 (42.66) 29 (38.66)
75 (100%) 75 (100%)
Education 3.8182 0.1482 NS
Illiterate 9 (12.00) 18 (24.00) df=2
Up to 10th 54 (72.00) 45 (60.00)
Up to Master 12 (16.00) 12 (16.00)
Degree 75 (100%) 75 (100%)
Domicile 1.7587 0.1842 NS
Rural 38 (50.66) 46 (61.33) df=1
Urban 37 (49.33) 29 (38.66)
75 (100%) 75 (100%)
395 Indian Journal of Health and Well-being 2020, 11(7-9), 393-397

groups of the patients (Schizophrenia & Manic). 75 Schizophrenics
and 75 Bipolar Affective Disorder currently manic patients were
taken to the study and diagnosed accordingly to DCR of ICD-10
criteria.
Table 1 and 2 is showing the socio-demographic characteristics of
schizophrenia and manic patients. The age group of the patient was
classified into three categories, i.e., 21-30, 31-40, 41-45. 30.66%
patients of schizophrenia and 29.33% patients of Manic were in age
range of 21-30 years. 54.66% in schizophrenia and 57.33% in mania
belongs to the age range of 31-40 years and 13.33% manic and
14.66% schizophrenic patients belongs to the age range of 41-45
years. Out of 75 manic patients 50 patients were male and 25 patients
were female and out of 75 patients of schizophrenia 48 patients were
male and 27 patients were female. In respect of martial status of
manic patients, 57.33% subjects married and 42.66% were
unmarried. Similarly, in schizophrenia 61.33% cases married and
38.66% were unmarried. About education, out of 75 patients, 9 were
illiterate, 54 patients educated up to matric level and 12 patients
educated up to master level in manic cases and in schizophrenia 18
patients were illiterate, 45 patients educated up to matric level and
12 patients were above matriculation. In respect of domicile, 38
patients were in rural area and 37 patients from urban background in
mania and in schizophrenia 46 patients were in rural area and 29
patients belongs to urban background.

Table 2
Showing religion, occupation, family type and socio-economic status of manic and schizophrenic
patients
Variables Mania Schizophrenia x2 df P Significance
N(%) N(%)
Religion 2.0895
Hindu 49 (65.33) 57 (76.00) df=2 0.3518 NS
Muslim 18 (24.00) 12 (16.00)
Others 08 (10.66) 06 (08.00)
75(100%) 75(100%)
Occupation 0.1425
Employment 46 (61.33) 48 (64.00) df=1 0.7058 NS
Unemployment 29 (38.66) 27 (36.00)
75(100%) 75(100%)
Family Type 0.4844
Nuclear 30 (40.00) 26 (34.66) df=1 0.4864 NS
Joint 45 (60.00) 49 (65.33)
75 (100%) 75 (100%)
Socio Economic
Status 1.1187 0.5716 NS
Upto Rs. 3,000 43 (57.33) 46 (61.33) df=2
Upto Rs.6,000 29 (38.66) 28 (37.33)
Above Rs. 6,000 03 (04.00) 01 (01.33)
75 (100%) 75 (100%)

The religion of patient was classified into three groups, Hindu,
Muslim and others. In respect of Mania, 65.33% patients were of
Hindu Community and 24% patients were Muslim and 10.66%
patients belong to other community. In respect of schizophrenia,
76.00% were Hindu, 16% were Muslim and 8% belongs to other
community. About occupation 61.33% patients were employed and
38.66% were unemployed in manic group and in schizophrenia, 64%
patients were employed and 36% patients were unemployed.
Categories of the family type in the two groups, i.e., nuclear and
joint. Out of 75 in Mania, a 40% patient belongs to nuclear family and
60% belongs to joint family and 34.66% patients belongs to nuclear
and 65.33% belongs to joint family in schizophrenia.
The socio-economic status of the patients was classified into three
categories, monthly income up to Rs. 3,000, up to Rs. 6,000 and
above Rs. 6,000. 57.33% patients were up to Rs. 3,000 monthly
income and 38.66% were up to Rs. 6,000 monthly income and 3%
were above Rs. 6,000 monthly income in manic group. Similarly in
schizophrenia, 61.33% patients were up to Rs.3,000 monthly
income and 37.33% patients were up to Rs. 6,000 and single patient
was above Rs.6,000 monthly income. x2 values suggested that there
is no significant difference in socio-demographic variables of
schizophrenia and mania.
Table 3 is showing the perceived social support of the subject in
two groups. The perceived social support was rated on the Social
Support Questionnaire (SSQ) which has 18 items and it is four point
rating scale. To know the statistical difference in the Social Support
of two groups, (Schizophrenia & Mania) “t” test was done.
The Mean and SD of the Manic group was 45.32 and 8.85, and in
schizophrenic group 41.80 and 7.37. “t” score was 2.647 which is
statistically significant on 0.01 level. Result indicate that
schizophrenic group has less perceived social support in comparison
to manic group.
 SINGH AND CHAKRABORTY/ A COMPARATIVE STUDY OF PERCEIVED SOCIAL SUPPORT
Table 3
Showing the Mean, SD and “t” values of perceived social support in Mania and
schizophrenia
Variables Mania
Mean SD
Social Support Questionnaire 45.32 8.85
**p < 0.01 level
Discussion
Clinical outcome of schizophrenia and Bipolar Affective Disorder
cannot be understood only from the point of view of
psychopathology. Psychological and environmental factors facilitate
or impede recovery and determine the prognostic status. So, personal
and environmental strengths are also extremely important and
require specific consideration. In this context the present study was
carried out which contributed same information application for
clinical intervention and for further research.
The present study examined the perceived social support in which
people having Schizophrenia and Bipolar Affective Disorder
(Mania). The present study is a comparison study which aim to
examine and compare the perceived social support in the
schizophrenic patients and Bipolar Affective Disorder (Manic)
Cases.
Sample was collected by purposive sampling method on OPD
basis and total size was 150. 75 patients were schizophrenic group
and 75 patients from manic groups. During a particular time period it
was more convenient to collect date purposively. It was time bound
study and it was not possible to first enlist all patients and then select
patients for the study, hence purposive sampling was used.
Subject of either sex between 21 to 45 years of age were selected.
This is a justifiable because in this age groups individual used to the
various role assignments in personal and social life. After 50-55
years of age the susceptibility to suffer with various physical illness
measures and life becomes more complicated, which could have
been affect the purpose of study.
This study was shown that the socio-demographic variables of
patients of schizophrenic and Bipolar Affective Disorder (Manic)
cases. The sample consisted of 150 patients of schizophrenia and
mania diagnosed accordingly to ICD-10 criteria. Socio-
demographic variables of the patients were divided in following
areas, i.e., age, sex, martial status, education, domicile, occupation,
family type, socio-economic status and religion of the patient.
Result shows about age factor of both age groups 57.33% in Mania
and 54.66% in schizophrenia patients belongs to age group of 31-40
years. In the area of sex variable 66.66% male patients were manic
group and 64.00% male patients from schizophrenic group. And in
both groups large number of married patients in Manic group. 43
patients were married and in schizophrenia group 46 patients were
married. Out of 150 in both groups 59.33% were married.
Hoeining and Hamilton (1966) found that factors like age, sex,
social class and martial status of the patients had little effect on the
burden, unlike the duration of the illness and patients
psychopathology. It was found that76% of patients had some kind of
396
Schizophrenia "t" value dt=148
Mean SD
41.80 7.37 2.647**
adverse effect on the households.
Brown (1972); and Vaughan and Leff (1985); had found that the
Brown and Birely (1972) and Vaughan and relapse rate of
schizophrenic was double in males than females and rate of relapse
was significantly in unmarried as compared to married.
About the educational status in both groups. 72% patients from
Manic and 60% schizophrenics were educated up to matric level.
Some studies shows that lower level of education (illiterate or
literate) is related to poor outcome in schizophrenia
About the occupation of the patients, result shows that 64%
patient in schizophrenic and 61.33% in Manic were employed. They
employed as Labour, or Mazdoor, etc.
Study shows that the quality of useful work or to meaningful work
involvement is a significant contributory factors to determine good
prognosis of the schizophrenia.
Results of the study shows that about socio-economic status
57.33% in mania and 61.33% in schizophrenic belongs to income of
below Rs 3,000.
Out of 75, three patients of mania and out of 75, one patient is
schizophrenic have monthly income was above Rs.6,000. Earlier
studies suggested that shorter educational history, lower income and
unemployment are associated with an increased risk for Bipolar
Affective Disorder.
Study indicated that single persons age 18 years and over were at
increased risk of Bipolar Disorders. Lower annual income and
receipt of sickness payment were all associated with increased risk
for Bipolar Disorders.
In the respect of domicile result shows that 51% in manic and 62%
in schizophrenics belongs to rural background. There are number of
study in India about domicile. And in maximum study suggested that
rural areas have more prone mental illness. Most of the
schizophrenic patients are found in rural background and they
belongs to low-socio economic status. 60% Manic and 66%
schizophrenic patients belongs to Joint family in respect of family
type.
However, studies shows (Bharat, 1991) found in ten out of twenty
studies reviewed that the nuclear type of families were more
irritability to psychiatric disorders than Joint family.
Sharma and Srivastva (1991) also arrived at a similar conclusion.
Psychiatric Disorders to the lack of a supportive network in a nuclear
type family in comparison to a Joint family.
About religion of the patients, 49 patients were in Manic group
and 57 schizophrenic patients belongs to Hindu Community.
For the compare of Socio-demographic variables of
schizophrenia and Manic. Chi square (x2) has been done. But result
397 Indian Journal of Health and Well-being 2020, 11(7-9), 393-397
shows that there was no significant in any area of socio-demographic
variables of each age, sex, martial status, domicile etc in Manic and
Schizophrenic patients.
Compared the perceived social support of schizophrenic and
Manic patients.
Mean Value of the social support in Manic group was 45.32 and in
schizophrenic group 41.80 and df=148 and “t” value was 2.647 and it
was significant on 0.01 level.
It has been well documented that low level of perceived social
support are related to psychological distress (Cohen & Will, 1985).
Previous research was indicated social support is a particularly
important factor in assisting people with schizophrenic to remain in
community (Hatfield, 1979; Thompson & Doll, 1982). However, it is
the degree to which people with schizophrenia perceive themselves
to be supported that is crucial importance (Turner, 1981).
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Received July 16, 2020
Revision received July 25, 2020
Accepted July 25, 2020
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