The Effect of Interpersonal Relationships and Social Rhythm Therapy on Biological Rhythm and Relapses in Individuals With Bipolar Disorder

Interpersonal and Social Rhythm Therapy (IPSRT) is a type of psychotherapy that applies social rhythm theories in bipolar disorder. The purpose of IPSRT is to stabilize people's social routines (daily routines, sleep-wake balances), gain insight into the two-way relationship between interpersonal events and mood, and increase their satisfaction with social roles.The main purpose is to increase functionality in bipolar disorder. Using this versatile approach, IPSRT aims to improve current mood and teach patients skills to protect themselves against the development of new bipolar episodes. In individuals with bipolar disorder; Non-compliance with pharmacological treatment, stressful life events and disturbances in social rhythms cause relapses. As a component of KIPT-SRT is psychoeducation, education about the disease and treatment is provided to ensure compliance with pharmacological treatment IPSRT seeks to reduce patients' interpersonal and social-based stress factors by addressing interpersonal and social role problems. It also increases the stability of social rhythms by organizing daily routines, paying attention to the extent to which positive and negative life events can affect these daily routines Psychiatric nursing is an interpersonal process in which a professional nurse helps to improve the mental health of the individual, family and society, to prevent mental illness and suffering experiences or to cope with the disease and, if necessary, to find meaning from these experiences (Kum,1996; Çam, 2014). Peplau, one of the psychiatric nursing theorists, believed that many nursing problems arise from human relationships, and nursing interventions should be planned in this direction in order for individuals to continue their development and to solve these problems. The interpersonal process is at the center of the model, as nurses can recognize and help solve problems arising from human relationships. Interview steps of IPSRT, which has features that overlap with Peplau's theory of interpersonal relations, are seen to be parallel with Peplau's relationship steps between nurse and patient. On the basis of this theory, the application of IPSRT can be used as an important strategy by psychiatric nurses in reducing the frequency of recurrence in bipolar disorder patients who continue to experience bipolar attacks. This study will be carried out in order to evaluate the difference in terms of biological rhythm and recurrence frequency between the intervention and control group of IPSRT based on Peplau's theory of Interpersonal Relationships This study was planned as a follow-up study in a quantitative, randomized controlled experimental design, aiming to determine the effectiveness of Peplau's Interpersonal Relations theory-based IPSRT applied to individuals with bipolar disorder to determine the effect on biological rhythm, interpersonal relationships and relapse frequencies. Pre-intervention pre-test, post-intervention post-test and follow-up scheme will be used. To carrying out of this study, first of all, intervention and control groups will be formed by randomization according to gender and bipolar type (I-II), using the Introductory Information Form, Young Mania Rating and Hamilton Depression Rating Scales from individuals with bipolar disorder registered to the Community Mental Health Service (CMHS). As a pre-test (Introductory Information Form, Young Mania Rating Scale, Hamilton Depression Rating Scale, Biological Rhythm Assessment Interview, Interpersonal Competence Scale) to the intervention and control groups, Peplau Interpersonal Relations based IPSRT will be applied to the intervention group, and the control group will be given a CMHS and will also continue the treatment. IPSRT will take 40-45 minutes twice in a week and will be conducted in 10-12 individual meetings in total. Immediately, 1 month and 3 months after the interviews, post-tests will be applied to the intervention and control groups.

With this study, the biological rhythms of IPSRT individuals based on Peplau Interpersonal Relationship Theory in bipolar disorder will be regulated and the frequency of relapse will decrease. In addition, individuals with bipolar disorder, which is one of the lifelong mental illnesses that cause stigmatization, will continue their lives in the community, their functionality will increase in their work life, school life and social life, and hospitalization will decrease