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Factors associated with functional recovery in bipolar disorder patients


  • RJB has recently been a consultant or investigator-initiated research collaborator with Auritec, Biotrofix, IFI, Janssen, JDS, Eli Lilly & Co., Luitpold, Merck, NeuroHealing, Novartis, Pfizer, and SK-BioPharmaceuticals Corporations, but is not a member of pharmaceutical speakers bureaus, nor does he or any family member hold equity positions in biomedical or pharmaceutical corporations. PEH has been a consultant to Advanced Neuromodulation Systems, AstraZeneca, and Tetragenex Corporations. PDH has received research support from AstraZeneca; and has been a recent consultant to Eli Lilly & Co., Johnson & Johnson, Merck, Shire, and Dainippon-Sumitomo/America Corporations. APW has no relevant potential conflicts of interest.

Corresponding author:
Dr. Aliza P. Wingo
Department of Psychiatry and Behavioral Sciences
Emory University
101 Woodruff Circle, NE (Suite 4000)
Atlanta, GA 30322, USA
Fax: 404-727-3233


Wingo AP, Baldessarini RJ, Holtzheimer PE, Harvey PD. Factors associated with functional recovery in bipolar disorder patients.
Bipolar Disord 2010: 12: 319–326. © 2010 The Authors.
Journal compilation © 2010 John Wiley & Sons A/S.

Objectives:  Among bipolar disorder (BPD) patients, functional recovery, defined as regaining individual premorbid residential and vocational status, is far less common than symptomatic recovery. As several factors have tentatively been implicated in outcomes in BPD, we investigated predictors of functional recovery among BPD patients, including demographic, clinical, and neurocognitive factors.

Methods:  We assessed functional recovery status with standardized residential and occupational indices, assessed neurocognitive functioning with performance-based neuropsychological tests, and collected demographic and clinical information for 65 euthymic or residually depressed Structured Clinical Interview for DSM-IV-defined type I or II BPD patients. We examined predictors of functional recovery with multiple logistic regression modeling.

Results:  More education (p = 0.006), fewer years of illness (p = 0.037), and being married (p = 0.045) were associated independently with functional recovery, even after controlling for residual depressive symptoms, diagnostic type (I versus II), and psychiatric comorbidity. Functionally unrecovered BPD patients performed less well than recovered patients on verbal fluency (effect size = 0.54, p = 0.03), a measure of executive functioning, but this difference was not significant when adjusted for residual mood symptoms and education.

Conclusions:  Among euthymic or mildly depressed BPD patients, functional recovery was associated with more education, being married, and fewer years of illness.