title: Subsyndromal depressive symptoms after symptomatic recovery from mania are associated with delayed functional recovery.
abstract: OBJECTIVE
  This study examined whether the presence of subsyndromal depressive symptoms predicted functional recovery after an acute manic episode.
  
  
  METHODS
  Subjects with bipolar I disorder (according to the Structured Clinical Interview for DSM-IV) who, at the time of symptomatic recovery from an acute manic or hypomanic episode, had a concomitant functional recovery (n = 52) were compared on demographic variables and mood symptoms to those who had symptomatically recovered but not functionally recovered (n = 33). Demographic and mood variables were examined in the nonfunctionally recovered group to assess predictors of time to functional recovery. The primary functional outcome measure used was the Life Functioning Questionnaire, a 5-minute, gender-neutral self-report scale to measure role function in 4 domains: workplace, duties at home, leisure time with family, and leisure time with friends. Participants in the study were recruited from July 2000 through February 2005.
  
  
  RESULTS
  Depressive symptoms, even at a subsyndromal level, were significantly associated with persisting functional impairment after symptomatic recovery from a manic episode (P < .02). Subsyndromal depressive symptoms also significantly predicted a slower time to functional recovery over the next 9 months (P = .006).
  
  
  CONCLUSIONS
  The presence of even mild subsyndromal depressive symptoms may interfere with functional recovery in patients with bipolar disorder after symptomatic recovery from a manic or hypomanic episode.
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine at the University of California, Los Angeles, CA, USA. mgitlin@mednet.ucla.edu
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Gitlin
authors.forename: Jim
authors.initials: J
authors.lastname: Mintz
authors.forename: Kenneth
authors.initials: K
authors.lastname: Sokolski
authors.forename: Constance
authors.initials: C
authors.lastname: Hammen
authors.forename: Lori L
authors.initials: LL
authors.lastname: Altshuler
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000339:Affect; D018692:Antimanic Agents / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy / Q000523:psychology*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D016896:Treatment Outcome
chemical_list: D018692:Antimanic Agents; D014150:Antipsychotic Agents