Factors associated with poor functional outcome in bipolar disorder: sociodemographic, clinical, and neurocognitive variables

Sanchez-Moreno, José; Bonnín, C.M.; González‐Pinto, Ana; Amann, Benedikt L.; Solé, Brisa; Balanzá‐Martínez, Vicent; Arango, Celso; Jiménez, Esther; Tabarés‐Seisdedos, Rafael; García-Portilla, María Paz; Ibáñez, Ángela; Crespo, José Manuel; Ayuso-Mateos, José Luís; Martínez-Àran, Anabel; Torrent, Carla; Vieta, Eduard

doi:10.1111/acps.12894

Cited by 68 publications

(40 citation statements)

References 76 publications

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“…These pragmatic needs, however, have limited the field and prevented developments. Excessive reliance on symptoms that are part of diagnostic criteria of mental disorders (e.g., major depressive disorder and generalized anxiety disorder) has impoverished clinical assessment in psychotherapy research and does not reflect the broad spectrum of variables that affect clinical presentations, such as demoralization and irritable mood [2], psychological well-being and euthymia [67,68], mental pain [69], social adjustment and functioning [70][71][72], illness behavior [2,73], and patient satisfaction [73]. Patient-reported outcomes [66] are frequently used in psychotherapy research.…”

Section: Assessmentmentioning

confidence: 99%

Methodological Recommendations for Trials of Psychological Interventions

Guidi

Brakemeier

Bockting

et al. 2018

Psychother Psychosom

189

178

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Recent years have seen major developments in psychotherapy research that suggest the need to address critical methodological issues. These recommendations, developed by an international group of researchers, do not replace those for randomized controlled trials, but rather supplement strategies that need to be taken into account when considering psychological treatments. The limitations of traditional taxonomy and assessment methods are outlined, with suggestions for consideration of staging methods. Active psychotherapy control groups are recommended, and adaptive and dismantling study designs offer important opportunities. The treatments that are used, and particularly their specific ingredients, need to be described in detail for both the experimental and the control groups. Assessment should be performed blind before and after treatment and at long-term follow-up. A combination of observer- and self-rated measures is recommended. Side effects of psychotherapy should be evaluated using appropriate methods. Finally, the number of participants who deteriorate after treatment should be noted according to the methods that were used to define response or remission.

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Section: Assessmentmentioning

confidence: 99%

Methodological Recommendations for Trials of Psychological Interventions

Guidi

Brakemeier

Bockting

et al. 2018

Psychother Psychosom

189

178

View full text Add to dashboard Cite

show abstract

“…Concerning the sociodemographic factors, it seems that male patients (Tohen et al, 1990; Sanchez-Moreno et al, 2018) as well as older patients (Sanchez-Moreno et al, 2018) show poorer functional outcomes. On the other hand, being married could represent a protective factor against functional impairment (Kupfer et al, 2002; Wingo et al, 2010).…”

Section: Variables Influencing Functional Outcome In Bdmentioning

confidence: 99%

Improving Functioning, Quality of Life, and Well-being in Patients With Bipolar Disorder

Bonnín

Reinares

Martínez‐Arán

et al. 2019

International Journal of Neuropsychopharmacology

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People with bipolar disorder frequently experience persistent residual symptoms, problems in psychosocial functioning, cognitive impairment, and poor quality of life. In the last decade, the treatment target in clinical and research settings has focused not only on clinical remission, but also on functional recovery and, more lately, in personal recovery, taking into account patients’ well-being and quality of life. Hence, the trend in psychiatry and psychology is to treat bipolar disorder in an integrative and holistic manner. This literature review offers an overview regarding psychosocial functioning in bipolar disorder. First, a brief summary is provided regarding the definition of psychosocial functioning and the tools to measure it. Then, the most reported variables influencing the functional outcome in patients with bipolar disorder are listed. Thereafter, we include a section discussing therapies with proven efficacy at enhancing functional outcomes. Other possible therapies that could be useful to prevent functional decline and improve functioning are presented in another section. Finally, in the last part of this review, different interventions directed to improve patients’ well-being, quality of life, and personal recovery are briefly described.

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“…those with rapid cycling or with high numbers of manic relapses, in order to improve treatment adherence and the clinical course of BD. Moreover, the long-term impact of those compounds on cognitive and functional outcomes, which are heavily influenced by the number of manic recurrences ( Sanchez-Moreno et al, 2018 ), should be addressed. Future studies should also focus on site of injection (deltoid vs .…”

Section: Article In Pressmentioning

confidence: 99%

Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review

Pacchiarotti

Tiihonen

Kotzalidis

et al. 2019

European Neuropsychopharmacology

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Long-Acting Injectable Antipsychotics (LAIs) are used to overcome non-compliance in psychoses, mainly schizophrenia spectrum disorders. We aimed to summarize available evidence of studies comparing the efficacy of LAIs to placebo or oral medications for Bipolar Disorder JID: NEUPSY [m6+; February 12, 2019;11:45 ] Long-acting injectable antipsychotic treatment; Risperidone long-acting; Paliperidone palmitate long-acting injectable; Aripiprazole monohydrate long-acting injectable (BD) and/or Schizoaffective Disorder (SAD). We searched six databases from inception to 28-March-2018, using the strategy: long-acting antipsychotics AND (bipolar disorder OR schizoaffective disorder OR mania OR manic OR bipolar depression). We included peer-reviewed double-blind comparisons of LAIs for any clinical outcome occurrence in BD, or open mirror studies with same prospective as retrospective assessment periods. We excluded studies reporting on mixed schizophrenia/SAD populations without reporting results separately. The pooled records amounted to 642. After duplicate removal and inclusion/exclusion criteria application, we included 15 studies, 6 double-blind and 9 open, 13 assessing BD and 2 SAD. Depot neuroleptics prevented manic, but not depressive recurrences and may worsen depressive symptoms. Risperidone long-acting injectable was found to be effective in protecting from any mood/manic symptom compared to placebo, but not from depressive recurrences. Add-on or monotherapy paliperidone palmitate in SAD patients protected from psychotic, depressive, and manic symptoms. In patients with BD-I with a manic episode at study enrolment, aripiprazole monohydrate significantly delayed time to recurrence of manic episodes without inducing depressive episodes. LAIs are effective and well-tolerated maintenance treatments for BD and SAD. They showed better efficacy in preventing mania than depression. LAIs may be first-line for BD-I and SAD patients with a manic predominant polarity and with non-adherence problems.

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Factors associated with poor functional outcome in bipolar disorder: sociodemographic, clinical, and neurocognitive variables

Abstract: Male gender, older age, lower premorbid IQ, subdepressive symptoms, higher number of manic episodes, and lower performance in verbal memory, working memory, verbal fluency, and processing speed were associated with lower functioning in patients with BD.

Cited by 68 publications

References 76 publications

Methodological Recommendations for Trials of Psychological Interventions

Methodological Recommendations for Trials of Psychological Interventions

Improving Functioning, Quality of Life, and Well-being in Patients With Bipolar Disorder

Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review

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