Factors Associated with Functional Recovery in Bipolar Disorder Patients

• Type of Material: Article
• Authors: Aliza Wingo, Emory University; Ross J. Baldessarini, Harvard University; Paul E Holtzheimer, Emory University; Philip D. Harvey, Emory University
• Language: English
• Date: 2010-05
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S
• Final Published Version (URL): http://onlinelibrary.wiley.com/doi/10.1111/j.1399-5618.2010.00808.x/abstract
• Title of Journal or Parent Work: Bipolar Disorders
• ISSN: 1398-5647
• Volume: 12
• Issue: 3
• Start Page: 319
• End Page: 326
• Grant/Funding Information: Supported by an APIRE research fellowship from the American Psychiatric Institute of Research & Education (to APW), a grant from the Bruce J. Anderson Foundation and the McLean Private Donors Research Fund (to RJB), and NIH grant UL1 RR025008 (to APW).
• Keywords: marital status; bipolar disorder; illness duration; education; neurocognition; functional recovery
• Research Categories: Psychology, Cognitive; Health Sciences, Mental Health

Abstract

Objectives Among bipolar disorder (BPD) patients, functional recovery, defined as regaining individual premorbid residential and vocational status, is far less common than symptomatic recovery. As several factors have tentatively been implicated in outcomes in BPD, we investigated predictors of functional recovery among BPD patients, including demographic, clinical, and neurocognitive factors. Methods We assessed functional recovery status with standardized residential and occupational indices, neurocognitive functioning with performance-based neuropsychological tests, and collected demographic and clinical information for 65 euthymic or residually depressed, SCID-based DSM-IV type I or II BPD patients. We examined predictors of functional recovery with multiple logistic regression modeling. Results More education (p=0.006), fewer years of illness (p=0.037), and being married (p=0.045) were associated independently with functional recovery, even after controlling for residual depressive symptoms, diagnostic type (I vs. II), and psychiatric co-morbidity. Functionally unrecovered BPD patients performed less well than recovered patients on verbal fluency (ES=0.54, p=0.03), a measure of executive functioning, but this difference was not significant when adjusted for residual mood symptoms and education. Conclusions Among euthymic or mildly depressed BPD patients, functional recovery was associated with more education, being married, and fewer years of illness.