Facteurs prédictifs du fonctionnement chez les patients bipolaires de type 1 en période de rémission

Fekih‐Romdhane, Feten; Homri, W.; Mrabet, Ali; Labbane, R.

doi:10.11604/pamj.2016.25.66.8532

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…Previous studies have found that manic episodes were associated with poor occupational functioning, 46 and previous depressive episodes were associated with poor job performance 38,47 . Similar to the findings of our study, several studies have found that previous depressive episodes have a negative impact on general functioning, 48,49 while other studies have reported the adverse effects of manic episodes on functioning 50,51 …”

Section: Discussionsupporting

confidence: 89%

“…38,47 Similar to the findings of our study, several studies have found that previous depressive episodes have a negative impact on general functioning, 48,49 while other studies have reported the adverse effects of manic episodes on functioning. 50,51 Subthreshold symptoms are purportedly the most consistent predictors of level of functioning across studies. 51 Low levels of subthreshold depressive symptoms can influence functional outcomes, and previous evidence has shown that functional impairment increases significantly with each step up in depressive symptom severity.…”

Section: Discussionmentioning

confidence: 99%

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Psychosocial Impairment in Older Patients With Bipolar I Disorder

Vahapoğlu,

Aksoy Poyraz,

Özdemir

2024

Journal of Psychiatric Practice

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Background. The goal of this study was to assess psychosocial functioning in older patients with bipolar I disorder compared with healthy subjects and to identify the psychopathological factors associated with poor functioning in patients. Methods: We recruited 68 euthymic patients with bipolar I disorder from the outpatient unit and 89 healthy controls who were older than 50 years of age. In addition to clinical variables, we used other standardized measures, including the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Functional Assessment Short Test, and the Montreal Cognitive Assessment. Results. Older patients with bipolar I disorder had poorer psychosocial functioning in general and in the domains of occupation, autonomy, and cognition than the healthy controls on the basis of previously defined Functional Assessment Short Test cutoff scores. We found that 35.3% (95% CI: 23%-47%) of the patients did not have clinically significant functional impairment, 38.2% (95% CI: 26%-50%) had mild impairment, and 26.5% (95% CI: 16%-37%) had moderate impairment. Depressive symptoms and impaired cognition were associated with poor overall functioning. Conclusions. The level of psychosocial functioning was heterogeneous among the patients. Subsyndromal depressive symptoms, even at low levels, and impaired cognition predicted poor functioning in euthymic middle-aged and older patients with bipolar I disorder.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Psychosocial Impairment in Older Patients With Bipolar I Disorder

Vahapoğlu,

Aksoy Poyraz,

Özdemir

2024

Journal of Psychiatric Practice

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“…The degree of functional impairment in BD is heterogeneous and has consistently been associated with residual depressive symptoms and/or cognitive impairment in crosssectional studies (Baş et al, 2015;Samalin et al, 2016Samalin et al, , 2017Sanchez-Moreno et al, 2018). In addition, a lower level of functioning has been associated to male gender, older age, unemployment, a higher number of previous mood episodes and of hospitalizations, psychiatric comorbidities, sleep disorders or higher emotional reactivity (Fekih-Romdhane et al, 2016;Murru et al, 2018;Sanchez-Moreno et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Trajectories of functioning in bipolar disorders: A longitudinal study in the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort

Godin

Leboyer

Mazroui³

et al. 2020

Aust N Z J Psychiatry

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Objective: We aimed at identifying distinct trajectories of functioning and at describing their respective clinical characteristics in a cohort of individuals with bipolar disorders. Methods: We included a sample of 2351 individuals with bipolar disorders who have been followed-up to 3 years as part as the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort. Global functioning was measured using the Functioning Assessment Short Test. We used latent class mixed models to identify distinct longitudinal trajectories of functioning over 3 years. Multivariable logistic regression models were used to identify the baseline factors that were associated with the membership to each trajectory of functioning. Results: Three distinct trajectories of functioning were identified: (1) a majority of individuals (72%) had a stable trajectory of mild functional impairment, (2) 20% of individuals had a stable trajectory of severe functional impairment and (3) 8% of individuals had a trajectory of moderate functional impairment that improved over time. The membership to a trajectory of stable severe versus stable mild functional impairment was associated with unemployment, a higher number of previous hospitalizations, childhood maltreatment, a higher level of residual depressive symptoms, higher sleep disturbances, a higher body mass index and a higher number of psychotropic medications being prescribed at baseline. The model that included these seven factors led to an area under the curve of 0.85. Conclusion: This study enabled to stratify individuals with bipolar disorders according to three distinct trajectories of functioning. The results regarding the potential determinants of the trajectory of severe functional impairment needs to be replicated in independent samples. Nevertheless, these potential determinants may represent possible therapeutic targets to improve the prognosis of those patients at risk of persistent poor functioning.

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