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Six-month functional outcome of a bipolar disorder cohort in the context of a specialized-care program

Authors

  • Adriane R Rosa,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
    2. University Department of Psychiatry, Warneford Hospital, Oxford, UK
    3. Department of Pharmacology, University of Oxford, Oxford, UK
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  • Maria Reinares,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Benedikt Amann,

    1. Benito Menni, CASM, Research Unit, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
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  • Dina Popovic,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Carolina Franco,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Merce Comes,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Carla Torrent,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • C Mar Bonnín,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Brisa Solé,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Marc Valentí,

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • Manel Salamero,

    1. Department of Clinical Psychology, Institute of Neurosciences, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
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  • Flávio Kapczinski,

    1. Bipolar Disorders Program & INCT for Translational Medicine, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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  • Eduard Vieta

    1. Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
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  • FK has received grant/research support from AstraZeneca, Eli Lilly & Co., Janssen-Cilag, Servier, CNPq, CAPES, NARSAD, and the Stanley Medical Research Institute; has been a member of the speakers boards for AstraZeneca, Eli Lilly & Co., Janssen, and Servier; and has served as a consultant for Servier. EV has served as a consultant, advisor, or speaker for Almirall, AstraZeneca, Bial, Bristol-Myers Squibb, Cephalon, Eli Lilly & Co., Forest Research Institute, Geodon Richter, GlaxoSmithKline, Johnson & Johnson, Janssen-Cilag, Jazz, Lundbeck, Merck-Sharp & Dohme, Novartis, Organon, Otsuka, Pfizer, Sanofi-aventis, Servier, Takeda, and UBC. ARR, MR, BA, DP, CF, MC, CT CMB, BS, MV, and MS have no conflicts of interest to report.

Corresponding author:
Eduard Vieta, M.D., Ph.D.
Clinical Institute of Neuroscience
University Clinic Hospital of Barcelona
Villarroel 170
08036, Barcelona, Spain
Fax: +34932275795
E-mail: evieta@clinic.ub.es

Abstract

Rosa AR, Reinares M, Amann B, Popovic D, Franco C, Comes M, Torrent C, Bonnín CM, Solé B, Valentí M, Salamero M, Kapczinski F, Vieta E. Six-month functional outcome of a bipolar disorder cohort in the context of a specialized-care program. Bipolar Disord 2011: 13: 679–686. © 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S.

Objectives:  A marked disparity between functional recovery and symptomatic improvement has been demonstrated in bipolar disorder. However, most of the previous studies have been conducted in the United States, and there is little prospective research from Europe on this topic. The main objective of the present six-month follow-up study was to assess functioning in a sample of Spanish bipolar disorder patients following an acute episode or subsyndromal state. Additionally, we also evaluated the sensitivity to change of the Functioning Assessment Short Test (FAST).

Methods:  A total of 97 bipolar disorder patients with syndromal (n = 59) or subsyndromal (n = 38) symptoms were evaluated using the 17-item Hamilton Depression Rating Scale and Young Mania Rating Scale. The FAST was the primary measure to assess multiple areas of psychosocial functioning. Functioning was evaluated at four different time periods: baseline, 21 days, three months, and six months.

Results:  A significant improvement in global functioning was found in the whole sample over the six-month period, as indicated by a reduction of FAST total score (mean ± standard deviation) from 39.97 ± 15.10 to 30.65 ± 16.93 (= 36.104, p = 0.0001). This was also evident in all areas of functioning studied. However, only 26.4% of remitted patients (n = 42) achieved functional recovery, while 79.6% of the total sample (N = 97) experienced clinical remission of acute symptoms.

Conclusions:  Although many patients presented syndromal recovery, only a minority of them achieved favorable functioning in multiple areas, even after specialized mental health care. Furthermore, the FAST scale was sensitive to detect minimal changes in functioning in both short (21 days) and long (6 months) periods, which may be relevant to the use of this scale in clinical trials.

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