Subsyndromal depressive symptoms after symptomatic recovery from mania are associated with delayed functional recovery.
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.
Gitlin
Michael J
MJ
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
Mintz
Jim
J
Sokolski
Kenneth
K
Hammen
Constance
C
Altshuler
Lori L
LL
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
D018692:Antimanic Agents; D014150:Antipsychotic Agents