Factors associated with functional recovery in bipolar disorder patients.
OBJECTIVE
Among bipolar disorder (BPD) patients, functional recovery, defined as regaining individual premorbid residential and vocational status, is far less common than symptomatic recovery. As several factors have tentatively been implicated in outcomes in BPD, we investigated predictors of functional recovery among BPD patients, including demographic, clinical, and neurocognitive factors.


METHODS
We assessed functional recovery status with standardized residential and occupational indices, assessed neurocognitive functioning with performance-based neuropsychological tests, and collected demographic and clinical information for 65 euthymic or residually depressed Structured Clinical Interview for DSM-IV-defined type I or II BPD patients. We examined predictors of functional recovery with multiple logistic regression modeling.


RESULTS
More education (p = 0.006), fewer years of illness (p = 0.037), and being married (p = 0.045) were associated independently with functional recovery, even after controlling for residual depressive symptoms, diagnostic type (I versus II), and psychiatric comorbidity. Functionally unrecovered BPD patients performed less well than recovered patients on verbal fluency (effect size = 0.54, p = 0.03), a measure of executive functioning, but this difference was not significant when adjusted for residual mood symptoms and education.


CONCLUSIONS
Among euthymic or mildly depressed BPD patients, functional recovery was associated with more education, being married, and fewer years of illness.
Wingo
Aliza P
AP
Department of Psychiatry, Emory University, Atlanta, GA 30322, USA. aliza.wingo@emory.edu
Baldessarini
Ross J
RJ
Holtzheimer
Paul E
PE
Harvey
Philip D
PD
D000328:Adult; D001244:Association; D001288:Attention / Q000502:physiology; D001714:Bipolar Disorder / Q000150:complications*; D003072:Cognition Disorders / Q000209:etiology*; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D014706:Verbal Learning / Q000502:physiology