title: Early functional impairment in bipolar youth: a nested population-based case-control study.
abstract: OBJECTIVE
  The objective of this report is to evaluate functioning in bipolar disorder in a population-based sample of young adults (18 to 24 years old). To this end, people with bipolar disorder were compared with matched participants with only depressive episodes and control subjects without a history of mood episodes.
  
  
  METHODS
  Case-control study nested in a population-based sample. Caseness was confirmed with the Structured Clinical Interview for DSM-IV. The Functioning Assessment Short Test was used as a measure of general functioning. A multivariate model was elaborated to account for potential confounders.
  
  
  RESULTS
  The sample consisted of 231 subjects. Both bipolar disorder (coef=0.60, SE=0.14, p<0.001) and major depression (coef=0.44, SE=0.14, p=0.001) were associated with functioning in the multivariate model. Current depressive symptoms appeared to influence functioning in those with major depression (Z=2.05, p=0.04), but not in those with bipolar disorder (Z=0.78, p=0.43).
  
  
  CONCLUSIONS
  Neuropsychological testing was not performed and we see it as an important limitation of this study.
  
  
  CONCLUSIONS
  This population-based study further reinforces the notion that functional impairment is a fundamental characteristic of bipolar illness. It is present from early stages and is not completely explained by mood symptoms.
authors.affiliation: Universidade Católica de Pelotas, Rua Félix da Cunha, 412 Pelotas, 96010-000 Pelotas, RS, Brazil.
authors.forename: Karen
authors.initials: K
authors.lastname: Jansen
authors.forename: Pedro V S
authors.initials: PV
authors.lastname: Magalhães
authors.forename: Ricardo
authors.initials: R
authors.lastname: Tavares Pinheiro
authors.forename: Flávio
authors.initials: F
authors.lastname: Kapczinski
authors.forename: Ricardo Azevedo da
authors.initials: RA
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D016022:Case-Control Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D019966:Substance-Related Disorders / Q000453:epidemiology