title: Residual symptoms and functional performance in a large sample of euthymic bipolar patients in France (the OPTHYMUM study).
abstract: BACKGROUND
  Some residual symptoms were found to be associated with impaired functioning in euthymic bipolar patients, but their impact and relevance are unclear in clinical practice. We re-examined the functional influence of a large set of residual symptoms in 525 euthymic bipolar outpatients using self- and clinician-rated questionnaires (OPTHYMUM study).
  
  
  METHODS
  This was a multi-centre, cross-sectional, non-interventional study of adult bipolar outpatients. All patients were euthymic at the time of assessment (YMRS score <8 and BDRS ≤8). Patients with low functioning (GAF score <60) were compared with the rest of the sample. Patients filled in specific questionnaires concerning their perceptions of different residual and subsyndromal symptoms.
  
  
  RESULTS
  Ninety-seven (97) psychiatrists included 525 patients. Of them, 35 patients had a GAF score <60. These "low functioning patients" were more frequently unemployed, had presented more manic episodes and psychotic symptoms, used more atypical antipsychotics or benzodiazepines and received less adjunctive psychotherapy. Concerning residual symptoms, they had more frequent emotional subsyndromal symptoms, disruption of circadian rhythms and sexual disorders. They perceived some cognitive deficits and suffered more social and family stigma.
  
  
  CONCLUSIONS
  Our study used an arbitrary GAF cut-off score (60) to separate bipolar patients in two groups (low and satisfactory functioning).
  
  
  CONCLUSIONS
  Residual symptoms are associated with functional impairment and may represent specific treatment targets. A personalized approach through specific psychotherapeutic programs may lead to more efficient support by the clinician.
authors.affiliation: CHU Clermont-Ferrand, EA7280, Auvergne University, Clermont-Ferrand, France. Electronic address: lsamalin@chu-clermontferrand.fr.
authors.forename: Ludovic
authors.initials: L
authors.lastname: Samalin
authors.affiliation: CHU Clermont-Ferrand, EA7280, Auvergne University, Clermont-Ferrand, France; Fondation FondaMental, Créteil, France.
authors.forename: Pierre Michel
authors.initials: PM
authors.lastname: Llorca
authors.affiliation: CHU Pasteur, Nice, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Giordana
authors.affiliation: CHU Henri Mondor, Creteil, France.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Milhiet
authors.affiliation: CHU Henri Mondor, Creteil, France.
authors.forename: Liova
authors.initials: L
authors.lastname: Yon
authors.affiliation: CRHU Tours, INSERM U930, François Rabelais University, Tours, France.
authors.forename: Wissam
authors.initials: W
authors.lastname: El-Hage
authors.affiliation: CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France; Fondation FondaMental, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Courtet
authors.affiliation: Otsuka Pharmaceuticals France SAS, Rueil Malmaison, France.
authors.forename: Evguenia
authors.initials: E
authors.lastname: Hacques
authors.affiliation: Bristol-Myers Squibb, Rueil Malmaison, France.
authors.forename: Nabil
authors.initials: N
authors.lastname: Bedira
authors.affiliation: Bristol-Myers Squibb, Rueil Malmaison, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Filipovics
authors.affiliation: Bristol-Myers Squibb, Rueil Malmaison, France.
authors.forename: Rosine
authors.initials: R
authors.lastname: Arnaud
authors.affiliation: Bristol-Myers Squibb, Rueil Malmaison, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Dillenschneider
authors.affiliation: AP-HP, CHU Saint-Louis Lariboisière, F. Widal, Paris, France; INSERM UMRS 1144, Universités Paris Diderot et Paris Descartes, Paris, France; Fondation FondaMental, Créteil, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Bellivier
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003527:Cyclothymic Disorder / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires
keywords: Bipolar disorder; Functional performance; Functioning; Residual symptoms