1. Predictors of functional impairment in bipolar disorder: Results from 13 cohorts from seven countries by the global bipolar cohort collaborative.
- Author
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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, and Klaus, Federica
- Subjects
Humans ,Bipolar Disorder ,Prospective Studies ,Longitudinal Studies ,Affect ,Cohort Studies - 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.
- Published
- 2022