EV has served as consultant, advisor, or speaker for Almirall, AstraZeneca, Bial, Bristol-Myers Squibb, Eli Lilly & Co., Forest Research Institute, GlaxoSmithKline, Janssen-Cilag, Jazz, Lundbeck, Merck Sharp and Dohme, Novartis, Organon, Otsuka, Pfizer, Inc., Sanofi-aventis, Servier, and UBC. ARR, MR, CF, MC, CT, JS-M, AM-A, MS and FK have no reported conflicts of interest to disclose.
Clinical predictors of functional outcome of bipolar patients in remission
Version of Record online: 8 MAY 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard
Volume 11, Issue 4, pages 401–409, June 2009
How to Cite
Rosa, A. R., Reinares, M., Franco, C., Comes, M., Torrent, C., Sánchez-Moreno, J., Martínez-Arán, A., Salamero, M., Kapczinski, F. and Vieta, E. (2009), Clinical predictors of functional outcome of bipolar patients in remission. Bipolar Disorders, 11: 401–409. doi: 10.1111/j.1399-5618.2009.00698.x
- Issue online: 8 MAY 2009
- Version of Record online: 8 MAY 2009
- Received 10 July 2008, revised and accepted for publication 7 November 2008
- bipolar disorder;
- functional impairment;
Objectives: A number of studies have now shown that subjects with bipolar disorder (BD) have significant psychosocial impairment during interepisode intervals. This study was carried out to assess the level of functioning as well as to identify potential predictors of functioning in a well-defined, euthymic bipolar sample.
Methods: The study included 71 euthymic bipolar patients and 61 healthy controls. The Functioning Assessment Short Test (FAST) was used to assess multiple areas of functioning such as autonomy, occupational functioning, cognitive functioning, interpersonal relationships, financial issues, and leisure time. Multivariate analysis was used to determine the global and specific clinical predictors of outcome.
Results: Sixty percent (n = 42) of the patients had overall functional impairment (defined as a FAST total score > 11) compared to 13.1% (n = 8) of the control group (p = 0.001). Bipolar patients showed a worse functioning in all the areas of the FAST. Only four variables—older age, depressive symptoms, number of previous mixed episodes, and number of previous hospitalizations—were associated with poor functioning, on a linear regression model, which accounted for 44% of the variance (F = 12.54, df = 58, p < 0.001).
Conclusions: A substantial proportion of bipolar patients experience unfavorable functioning, suggesting that there is a significant degree of morbidity and dysfunction associated with BD, even during remission periods. Previous mixed episodes, current subclinical depressive symptoms, previous hospitalizations, and older age were identified as significant potential clinical predictors of functional impairment.