Evaluation of Functioning Levels and Associated Factors in Patients with Remission in Bipolar Disorder

Abstract

Introduction: The course of bipolar disorder (BD) is characterized by relapse and remission periods. Although the symptoms show a significant and sometimes almost complete improvement during remission, the patients' functioning levels may be lower compared to the premorbid period. This study aimed to compare the functional levels between patients with BD during remission period and healthy controls and to evaluate the factors related to the functional status of the patients. Methods: In this cross-sectional study, functioning levels of the BD-I patients, who were in remission for three months or longer, were compared with those of the healthy controls. Young Mania Rating Scale and Hamilton Depression Rating Scale were used to determine remission status, and Bipolar Disorder Functioning Questionnaire (BDFQ) was used to determine the level of functioning. Results: The study included 165 BD-I patients during remission and 63 healthy controls. The BDFQ scores of the patients including intellectual functioning, sexual functioning, feeling of stigmatization, introversion, relationships with friends, participation in social activities, daily activities and hobbies, and taking initiative were found to be statistically significantly lower than those of the controls. When the functioning comparisons were carried out within the patients considering the drugs they were using, the functioning levels including domestic functioning and introversion domains were found to be significantly impaired in those who use at least one antipsychotic in addition to the mood stabilizers than in those who use only mood stabilizers. Conclusion: In BD, the impairments within multiple functioning domains are observed even during remission periods. Besides targeting remission through pharmacological treatment, psychosocial interventions for functioning are also important in the treatment of these patients.

Mood, activity, and sleep measured via daily smartphone-based self-monitoring in young patients with newly diagnosed bipolar disorder, their unaffected relatives and healthy control individuals

“…BD often has an onset of symptoms during young age and may cause substantial functional impairments also before the time of diagnosis, and a progression of severity during years of untreated illness, stressing the need for early diagnosis and intervention [3][4][5]. An increasing focus has recently been on coexisting alterations in mood, activity and sleep, and loss of function, both during affective episodes, but also between affective episodes [6][7][8]. Currently, no objective biomarkers like blood tests or radiologic findings are available to diagnose or monitor BD.…”

Optimal Well-Being After Psychopathology: Prevalence and Correlates

“…At the same time, the majority of studies follow hospitalized patients, who may be unrepresentative of the entire population (Angst, 2008;Rottenberg et al, 2018). For people with bipolar disorders, research has found that changes in depression severity are associated with functional impairment, whereas mania or hypomania symptoms are inconsistently associated with functioning (Hacimusalar & Dog ˘an, 2019;Simon et al, 2007). There are also indications that bipolar I produces greater functional impairment relative to other mood disorders ( Judd et al, 2008).…”

Optimal well-being after psychopathology: Prevalence and correlates

“…At the same time, the majority of studies follow hospitalized patients who may be unrepresentative of the entire population (Angst, 2008;Rottenberg et al, 2018). For people with bipolar disorders, research has found that changes in depression severity are associated with functional impairment, while mania or hypomania symptoms are inconsistently associated with functioning (Simon et al, 2007;Hacimusalar & Doğan, 2019). There are also indications that bipolar I produces greater functional impairment relative to other mood disorders (Judd et al, 2008).…”