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Functional impairment in the remission phase of bipolar disorder
Author(s) -
Fagiolini Andrea,
Kupfer David J,
Masalehdan Azadeh,
Scott John A,
Houck Patricia R,
Frank Ellen
Publication year - 2005
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1111/j.1399-5618.2005.00207.x
Subject(s) - bipolar disorder , panic disorder , spectrum disorder , bipolar i disorder , psychology , mood , psychiatry , panic , population , bipolar ii disorder , medicine , clinical psychology , mania , anxiety , environmental health
Objectives: The purpose of this study was to evaluate functional impairment in a group of patients with bipolar disorder in remission and to determine the extent of relationships between overall functioning and current depressive, manic and panic spectrum symptoms. Method: A subset of the patient population at the Pittsburgh site of the Systematic Treatment Enhancement Program in Bipolar Disorder (STEP‐BD) study was evaluated in this study. The subsample comprises 103 male and female subjects with bipolar I disorder (n = 70), bipolar II disorder (n = 24), schizoaffective disorder – bipolar type (n = 4), or bipolar disorder NOS (n = 5). Subjects were evaluated in a period of remission (at least 4 weeks with no more than two depressive or manic symptoms). Subjects were assessed for overall functional status using the Work and Social Adjustment Scale (WSAS) and for current bipolar and panic spectrum symptoms using the Mood Spectrum Self‐Report questionnaire (MOODS‐SR) and Panic‐Agoraphobic Spectrum Self‐Report questionnaire (PAS‐SR). Results: The median WSAS total score in these remitted subjects was 14, indicating significant functional impairment. Regressing WSAS on current depressive, manic, and panic spectrum total scores, we observed a highly significant depressive spectrum effect ( t = 4.9, df = 94, p < 0.0001), but non‐significant panic and manic spectrum effects ( t = 1.3, df = 94, p = 0.19 and t = −1.8, df = 94, p = 0.07, respectively). Conclusion: Bipolar disorder is associated with functional deficits even during periods of sustained and substantial remission. The degree of functional impairment is correlated with the degree of depressive spectrum symptoms.