Clinical and neurocognitive predictors of functional outcome in bipolar euthymic patients: a long-term, follow-up study.
OBJECTIVE
To identify clinical and neurocognitive predictors of long-term functional outcome in patients with bipolar disorder


METHODS
A total of 32 subjects who met criteria for bipolar I or II disorder were recruited from the Barcelona Bipolar Disorder Program and were assessed clinically and neuropsychologically at baseline. After an average 4-year follow-up, they were interviewed with the Functioning Assessment Short Test (FAST) to assess functional outcome. Multivariate analyses were applied to identify clinical and neurocognitive predictors of functional outcome.


RESULTS
The main regression model for predictors of overall psychosocial functioning identified subclinical depressive symptoms (beta=0.516, t=3.51, p=0.002), and free delayed recall in a verbal memory task (beta=-0.314, t=-2.144, p=0.041), accounting for 36% of the variance. Specific predictors of occupational functioning were, again, subthreshold depression (beta=0.435, t=2.8, p=0.009) and a measure of executive function, digits backwards (beta=-0.347, t=-2.23, p=0.034). This model explained around 28% of the variance (corrected R(2)=0.28; F=6.38, gl=2, p=0.004).


CONCLUSIONS
Subdepressive symptomatology together with neurocognitive impairments related to verbal memory and executive functions are predictor variables of long-term functional outcome in bipolar disorder.
Bonnín
C M
CM
Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
Martínez-Arán
A
A
Torrent
C
C
Pacchiarotti
I
I
Rosa
A R
AR
Franco
C
C
Murru
A
A
Sanchez-Moreno
J
J
Vieta
E
E
D000328:Adult; D000339:Affect / Q000187:drug effects; D000927:Anticonvulsants / Q000627:therapeutic use; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077213:Lamotrigine; D016651:Lithium Carbonate / Q000627:therapeutic use; D008297:Male; D011939:Mental Recall / Q000187:drug effects; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011379:Prognosis; D011594:Psychometrics; D012917:Social Adjustment; D016896:Treatment Outcome; D014227:Triazines / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
D000927:Anticonvulsants; D018692:Antimanic Agents; D014227:Triazines; D016651:Lithium Carbonate; D014635:Valproic Acid; D000077213:Lamotrigine