Manic morbidity and executive function impairment as determinants of long-term psychosocial dysfunction in bipolar disorder

• Published in: Acta psychiatrica Scandinavica 2021-07, Vol.144 (1), p.72-81
• Main Authors: Lomastro, María Julieta, Valerio, Marina P, Szmulewicz, Alejandro G, Martino, Diego J
• Format: Article
• Language: English
• ISSN: 0001-690X; 1600-0447
• DOI: 10.1111/acps.13303

In this study, we aimed to evaluate the role of cognitive performance and measures of clinical course-including both syndromal and subsyndromal symptomatology-as determinants of the functional outcome of patients with Bipolar Disorder (BD) during a mean follow-up period of more than 4 years. Seventy patients with euthymic BD completed a neurocognitive battery at study entry. Clinical course was assessed prospectively for a period longer than 48 months by two measures: time spent ill (documented using a modified life charting technique) and density of affective episodes (defined as the number of depressive and hypo/manic episodes per year of follow-up). Psychosocial functioning was assessed during euthymia using the Functioning Assessment Short Test (FAST) total score at the end of follow-up period. Baseline deficits in phonological fluency, a measure of executive functions (β = -2.49; 95% CI = -3.98, -0.99), and density of hypo/manic episodes during follow-up (β = 6.54; 95% CI = 0.43, 12.65) were independently associated with FAST total score at the end of study. Although interrelated, manic morbidity and executive function impairments independently contribute to long-term psychosocial dysfunction in BD and could be potential targets of intervention.