학술논문
Predictors of functional impairment in bipolar disorder: Results from 13 cohorts from seven countries by the global bipolar cohort collaborative.
Document Type
article
Author
Burdick, Katherine; Millett, Caitlin; Yocum, Anastasia; Altimus, Cara; Andreassen, Ole; Aubin, Valerie; Belzeaux, Raoul; Berk, Michael; Biernacka, Joanna; Blumberg, Hilary; Cleare, Anthony; Diaz-Byrd, Claudia; Dubertret, Caroline; Etain, Bruno; Lagerberg, Trine; Leboyer, Marion; Martinez-Aran, Anabel; McElroy, Susan; Mitchell, Philip; Olie, Emilie; Olorunfemi, Phebe; Passerieux, Christine; Peters, Amy; Pham, Daniel; Polosan, Mircea; Potter, Julia; Sajatovic, Martha; Samalin, Ludovic; Schwan, Raymund; Shanahan, Megan; Solé, Brisa; Strawbridge, Rebecca; Stuart, Amanda; Torres, Ivan; Ueland, Torrill; Vieta, Eduard; Williams, Lana; Wrobel, Anna; Yatham, Lakshmi; Young, Allan; Nierenberg, Andrew; McInnis, Melvin; Forester, Brent; Fullerton, Janice; Frye, Mark; Gard, Sébastien; Godin, Ophelia; Haffen, Emmanuel; Eyler, Lisa; Klaus, Federica
Source
Bipolar Disorders. 24(7)
Subject
Language
Abstract
OBJECTIVES: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD. METHODS: Thirteen cohorts from 7 countries included n = 5882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived higher versus lower function as the dependent variable and selected clinical and demographic variables as predictors. RESULTS: We found high rates of functional impairment, ranging from 41 to 75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, the presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning. CONCLUSIONS: The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.