Development and psychometric evaluation of the Bipolar Functional Status Questionnaire (BFSQ).
OBJECTIVE
Persistently impaired psychosocial functioning has been recognized in many individuals with bipolar disorder. However, existing measures of functional disability have been adapted for use in bipolar disorder based mainly on those developed for use in other conditions. The present study involved the development and validation of a new patient self-report measure specific to bipolar disorder, the Bipolar Functional Status Questionnaire (BFSQ).


METHODS
Relevant constructs were identified, evaluated, and refined through an expert advisory panel in conjunction with patient interviews. Questionnaire items were vetted through iterative patient interviews. Psychometric properties were determined based on patient responses from implementation of the proposed 33-item questionnaire in an 11-site study of 596 patients with bipolar disorder across varied phases of illness.


RESULTS
Eight constructs were identified as fundamental to functional status in bipolar disorder: cognitive function, sleep, role functioning, emotional functioning, energy/vitality, social functioning, personal management, and sexual functioning. Psychometric validation supported item reduction to a 24-item unidimensional scale, with high internal consistency (coefficient alpha's = 0.93-0.95), high test-retest reliability (intraclass correlation coefficient = 0.86, 95% confidence interval = 0.82-0.89), strong convergent validity with other functional disability measures (r's > 0.70), and highly significant discriminant validity across illness phases, with large effect sizes (Cohen's d > 0.70).


CONCLUSIONS
The BFSQ is a psychometrically sound self-report measure that can be used to effectively quantify functional status across different clinical states in patients with bipolar disorder.
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA. joseph.goldberg@mssm.edu
Joseph F
JF
Goldberg
Lori D
LD
McLeod
Sheri E
SE
Fehnel
Valerie Sl
VS
Williams
Lynne R
LR
Hamm
Kim
K
Gilchrist
D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods*; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D019968:Sexual and Gender Disorders / Q000209:etiology; D012893:Sleep Wake Disorders / Q000209:etiology; D012919:Social Behavior; D011795:Surveys and Questionnaires / Q000592:standards