Predictive factors of functional outcome in patients with bipolar I disorder: a five-year follow-up

•Clinical course predicted psychosocial functioning in BD throughout time•Psychosocial functioning was also explained by the neurocognitive change•Verbal memory and changes in sustained attention were associated with functioning•The interventions aimed to promote the prevention of relapses should be...

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Published in:	Journal of affective disorders 2020-07, Vol.272, p.249-258
Main Authors:	López-Villarreal, Ana, Sánchez-Morla, Eva María, Jiménez-López, Estela, Martínez-Vizcaíno, Vicente, Aparicio, Ana Isabel, Mateo-Sotos, Jorge, Rodriguez-Jimenez, Roberto, Vieta, Eduard, Santos, José Luis
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Attention Bipolar disorder Bipolar Disorder - epidemiology Female Follow-up Follow-Up Studies Humans Male Memory Middle Aged Neurocognition Neuroprogression Neuropsychological Tests Psychosocial functioning Young Adult
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Summary:	•Clinical course predicted psychosocial functioning in BD throughout time•Psychosocial functioning was also explained by the neurocognitive change•Verbal memory and changes in sustained attention were associated with functioning•The interventions aimed to promote the prevention of relapses should be considered Functional impairment is commonly encountered among patients with bipolar disorder (BD) during periods of remission. The distribution of the impairment of the functional outcome is heterogeneous. The objective of this current investigation was to identify neurocognitive and clinical predictors of psychosocial functioning in a sample of patients with BD. Seventy-six patients (59.2% females) and 40 healthy controls (50% females), aged 18 to 55 years, were assessed using a comprehensive neurocognitive battery (six neurocognitive domains), and the Functioning Assessment Short Test (FAST), at baseline and after a 5-year follow-up. Stepwise regression models were used to identify predictor variables related to psychosocial functioning. The number of hospitalizations during the follow-up, the change occurred in the neurocognitive composite index (NCI change), and NCI at baseline explained 30.8% of the variance of functioning. The number of hospitalizations during the follow-up was the variable that explained a greater percentage of the variance (16.9%). Verbal memory at baseline and the change in sustained attention during the follow-up explained 10% and 5.9% of the variance of the psychosocial functioning, respectively. The interval of 5 years between the two assessments could be too short to detect a possible progression in functional outcome for the overall sample. The clinical course during the follow-up is the factor that has a greater impact on psychosocial functioning in patients with BD. Thus, the interventions aimed to promote prevention of relapses should be considered as essential for avoiding functional impairment in these patients.
ISSN:	0165-0327 1573-2517