title: Subsyndromal symptoms assessed in longitudinal, prospective follow-up of a cohort of patients with bipolar disorder.
abstract: BACKGROUND
  Many patients with bipolar disorder (BD) do not regain full function following an acute illness episode, but the extent to which this impairment is the result of persistent symptoms has not been well established. This study examined factors associated with persistent subsyndromal symptoms in a well characterized group of BD patients who were prospectively followed for an average of 3 years.
  
  
  METHODS
  Detailed life charting data from 138 patients with BD were reviewed. Patients were categorized into euthymic, subsyndromal or syndromal groups according to the clinical state during their most recent year of follow-up. The three groups were then examined with respect to comorbidity, function and treatment received.
  
  
  RESULTS
  Patients with subsyndromal symptoms had high rates of comorbid anxiety disorders, and were more likely to have increased rates of eating disorders as well. Patients with subsyndromal symptoms had lower global assessment of function (GAF) scores than euthymic patients, and had as many clinic contacts and medication trials as patients with full episodes of illness.
  
  
  CONCLUSIONS
  Persistent subsyndromal symptoms in BD patients are associated with high rates of comorbidity that is important to recognize and treat in order to optimize mood and functioning.
authors.affiliation: Mood Disorders Program, McMaster University, Hamilton, ON, Canada. macqueng@mcmaster.ca
authors.forename: Glenda M
authors.initials: GM
authors.lastname: MacQueen
authors.forename: Michael
authors.initials: M
authors.lastname: Marriott
authors.forename: Helen
authors.initials: H
authors.lastname: Begin
authors.forename: Janine
authors.initials: J
authors.lastname: Robb
authors.forename: Russell T
authors.initials: RT
authors.lastname: Joffe
authors.forename: L Trevor
authors.initials: LT
authors.lastname: Young
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000209:etiology; D001521:Behavior Therapy; D001714:Bipolar Disorder / Q000453:epidemiology / Q000503:physiopathology*; D015331:Cohort Studies; D015897:Comorbidity; D003710:Demography; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004565:Electroconvulsive Therapy; D001068:Feeding and Eating Disorders / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents