Do patients with bipolar disorder and subsyndromal symptoms benefit from functional remediation? A 12-month follow-up study

• Published in: European neuropsychopharmacology 2017-04, Vol.27 (4), p.350-359
• Main Authors: Sanchez-Moreno, Jose, Bonnín, Caterina, González-Pinto, Ana, Amann, Benedikt L, Solé, Brisa, Balanzá-Martínez, Vicent, Arango, Celso, Jimenez, Esther, Tabarés-Seisdedos, Rafael, Garcia-Portilla, M. Paz, Ibáñez, Angela, Crespo, Jose Manuel, Ayuso-Mateos, Jose Luis, Vieta, Eduard, Martinez-Aran, Anabel, Torrent, Carla
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Bipolar disorder; Bipolar Disorder - rehabilitation; Chi-Square Distribution; Cognitive Remediation - methods; Female; Follow-Up Studies; Functional remediation; Humans; Internal Medicine; Male; Middle Aged; Psychiatric Status Rating Scales; Psychiatry; Psychotherapy - methods; Subsyndromal symptoms; Treatment; Treatment Outcome
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/j.euroneuro.2017.01.010

Abstract We analyzed the efficacy of functional remediation, in a sample of patients with bipolar disorder who presented with subsyndromal symptoms. From a total sample of 239 patients with bipolar I and II disorder, according to DSM-IV-TR diagnostic criteria, entering a randomized clinical trial, those patients who presented with subsyndromal symptoms were selected based on a method already described by Berk and colleagues was applied. It consists of using the Clinical Global Impression-Bipolar version (CGI-BP) to establish the scores of the Hamilton Depression Rating Scale (HAM-D) and of the Young Mania Rating Scale (YMRS) that correspond with 1 in the CGI-BP. Functional outcome and mood symptoms were assessed at 6 and at 12-month follow-up. A total of 99 patients were selected for this post-hoc analysis, allocated as follows: functional remediation ( n =33); psychoeducation ( n =37) and treatment as usual (TAU, n =29). The repeated-measures analyses at 12-month follow-up revealed a significant group x time interaction in favour of the patients who received functional remediation when compared to psychoeducation and TAU ( F =2.93; p =0.02) at improving psychosocial functioning. Finally, mood symptoms did not significantly change in any of the three groups at any time of follow-up, as shown by the non-significant group x time interaction effect in HAM-D scores ( F =1.57; p =0.18) and YMRS scores ( F =1.51; p =0.20). Bipolar patients with subsyndromal symptoms improve their functional outcome when exposed to functional remediation regardless of the persistence of mood symptomatology.