title: Predictors of functional outcome after a manic episode.
abstract: BACKGROUND
  The identification of functional outcome predictors after acute episodes of bipolar disorders (BD) may allow designing appropriate treatment aiming at restoring psychosocial functioning. Our objective was to identify the best functional outcome predictors at a 6-month follow-up after an index manic episode.
  
  
  METHODS
  We conducted a naturalistic trial (MANACOR) focusing on the global burden of BD, with special emphasis on manic episode-associated costs. We observed patients with BD seen in services of four hospitals in Catalonia (Spain).The total sample included 169 patients with chronic DSM-IV-TR BD I suffering from an acute manic episode who were followed-up for 6 months. In this subanalysis we report the results of a stepwise multiple regression conducted by entering in the model those clinical and sociodemographic variables that were identified through preliminary bivariate Pearson correlations and using total scores on the Functioning Assessment Short Test (FAST) at the 6-month follow-up as the dependent variable.
  
  
  RESULTS
  Number of previous depressive episodes (Beta=3.25; t=3.23; p=0.002), presence of psychotic symptoms during the manic index episode (Beta=7.007; t=2.2; p=0.031) and the Body Mass Index (BMI) at baseline (Beta=0.62; t=2.09; p=0.041) were best predictors of functional outcome after a manic episode.
  
  
  CONCLUSIONS
  The main limitations of this study include the retrospective assessment of the episodes, which can be a source of bias, and the 6-month follow-up might have been too short for assessing the course of a chronic illness.
  
  
  CONCLUSIONS
  Psychotic symptoms at index episode, number of past depressive episodes, and BMI predict worse outcome after 6 months follow-up after a manic episode, and may constitute the target of specific treatment strategies.
authors.affiliation: Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Barcelona, Spain.
authors.forename: C Mar
authors.initials: CM
authors.lastname: Bonnín
authors.affiliation: Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Barcelona, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Reinares
authors.affiliation: Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Barcelona, Spain.
authors.forename: Diego
authors.initials: D
authors.lastname: Hidalgo-Mazzei
authors.affiliation: Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Barcelona, Spain; Department of Psychiatry, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile.
authors.forename: Juan
authors.initials: J
authors.lastname: Undurraga
authors.affiliation: Psychiatric Service, Santa Maria Hospital, IRB Lleida (Biomedicine Research, Institute), University of Lleida, Catalonia, Lleida, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Mur
authors.affiliation: University Psychiatric Hospital, Institut Pere Mata, CIBERSAM, Reus, Catalonia, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sáez
authors.affiliation: Mental Health Division of Althaia, Xarxa Assistencial Universitària de Manresa, Catalonia, Spain.
authors.forename: Evaristo
authors.initials: E
authors.lastname: Nieto
authors.affiliation: Department of Neuroscience, Palermo University, Buenos Aires, Argentina.
authors.forename: Gustavo H
authors.initials: GH
authors.lastname: Vázquez
authors.affiliation: Psychiatric Service, La Fe University and Polytechnic Hospital, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain; Department of Medicine, University of Valencia, CIBERSAM, INCLIVA, Valencia, Spain.
authors.forename: Vicent
authors.initials: V
authors.lastname: Balanzá-Martínez
authors.affiliation: Psychiatric Service, La Fe University and Polytechnic Hospital, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Tabarés-Seisdedos
authors.affiliation: Bipolar Disorders Unit, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Catalonia, Barcelona, Spain. Electronic address: evieta@clinic.ub.es.
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology* / Q000628:therapy*; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D013030:Spain; D016896:Treatment Outcome
keywords: Bipolar disorder; Follow-up; Functional outcome; Manic episode; Predictive variables