title: Six-month functional outcome of a bipolar disorder cohort in the context of a specialized-care program.
abstract: OBJECTIVE
  A marked disparity between functional recovery and symptomatic improvement has been demonstrated in bipolar disorder. However, most of the previous studies have been conducted in the United States, and there is little prospective research from Europe on this topic. The main objective of the present six-month follow-up study was to assess functioning in a sample of Spanish bipolar disorder patients following an acute episode or subsyndromal state. Additionally, we also evaluated the sensitivity to change of the Functioning Assessment Short Test (FAST).
  
  
  METHODS
  A total of 97 bipolar disorder patients with syndromal (n = 59) or subsyndromal (n = 38) symptoms were evaluated using the 17-item Hamilton Depression Rating Scale and Young Mania Rating Scale. The FAST was the primary measure to assess multiple areas of psychosocial functioning. Functioning was evaluated at four different time periods: baseline, 21 days, three months, and six months.
  
  
  RESULTS
  A significant improvement in global functioning was found in the whole sample over the six-month period, as indicated by a reduction of FAST total score (mean ± standard deviation) from 39.97 ± 15.10 to 30.65 ± 16.93 (F = 36.104, p = 0.0001). This was also evident in all areas of functioning studied. However, only 26.4% of remitted patients (n = 42) achieved functional recovery, while 79.6% of the total sample (N = 97) experienced clinical remission of acute symptoms.
  
  
  CONCLUSIONS
  Although many patients presented syndromal recovery, only a minority of them achieved favorable functioning in multiple areas, even after specialized mental health care. Furthermore, the FAST scale was sensitive to detect minimal changes in functioning in both short (21 days) and long (6 months) periods, which may be relevant to the use of this scale in clinical trials.
authors.affiliation: Bipolar Disorders Program, Institute of Neurosciences, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
authors.forename: Adriane R
authors.initials: AR
authors.lastname: Rosa
authors.forename: Maria
authors.initials: M
authors.lastname: Reinares
authors.forename: Benedikt
authors.initials: B
authors.lastname: Amann
authors.forename: Dina
authors.initials: D
authors.lastname: Popovic
authors.forename: Carolina
authors.initials: C
authors.lastname: Franco
authors.forename: Merce
authors.initials: M
authors.lastname: Comes
authors.forename: Carla
authors.initials: C
authors.lastname: Torrent
authors.forename: C Mar
authors.initials: CM
authors.lastname: Bonnín
authors.forename: Brisa
authors.initials: B
authors.lastname: Solé
authors.forename: Marc
authors.initials: M
authors.lastname: Valentí
authors.forename: Manel
authors.initials: M
authors.lastname: Salamero
authors.forename: Flávio
authors.initials: F
authors.lastname: Kapczinski
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000523:psychology*; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D020127:Recovery of Function / Q000502:physiology*; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents