There is a lot of data on symptoms and the clinical outcome of bipolar disorder, but very limited data on what really matters to the patients and their relatives: functioning. An understanding of which domains of psychosocial functioning are mostly impaired in bipolar patients would be of clinical utility; as such information could contribute to the development of interventions focused upon functional restoration.

The objective was to assess specific life domains of functioning as well as the overall functioning in patients with bipolar disorder across different mood states (mania, depression, and remission). The sample was recruited via the Bipolar Disorders Program of the Hospital Clinic at the University of Barcelona (Spain), an internationally recognized center of excellence in bipolar disorder research.

The results showed that patients in acute episode experienced significantly poorer functioning compared to the euthymic and control groups across all domains. Particularly, participants in the depressive group showed more impairment than those in the (hypo) manic group in specific areas such as: autonomy, cognitive functioning, interpersonal relationships and leisure time as well as poorer overall functioning.

A number of studies have shown that a substantial proportion of bipolar patients experiencing unfavorable functioning extends to essentially all the areas of functioning. The severity of mood symptomatology has been associated with functional impairment in this population.

As Dr. Vieta says, "The results suggest those patients with depressive and manic episodes experience poor psychosocial functioning in distinct areas, and that those deficits persist in an attenuated form during periods of remission. These findings highlight the importance of treating both the symptoms of mania and depression aggressively, and also suggest that when patients are euthymic (in clinical remission), treatment should focus on rehabilitation measures to improve functioning".

This will be discussed in a future issue of Value in Health, the official journal of the International Society for Pharmacoeconomics and outcomes Research.

Source:
ISPOR