Clinical predictors of functional outcome of bipolar patients in remission.
OBJECTIVE
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.
Rosa
Adriane R
AR
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona 08036, Spain.
Reinares
Maria
M
Franco
Carolina
C
Comes
Mercè
M
Torrent
Carla
C
Sánchez-Moreno
Jose
J
Martínez-Arán
Anabel
A
Salamero
Manel
M
Kapczinski
Flávio
F
Vieta
Eduard
E
D000203:Activities of Daily Living; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D004651:Employment; D005260:Female; D005382:Financing, Personal; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D026684:Personal Autonomy; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D011795:Surveys and Questionnaires