Predictors of High Psychosocial Functioning in Bipolar Disorder

Abstract

The aim of this study was to identify predictors of high psychosocial functioning in patients with bipolar disorder (BD). One hundred forty-five outpatients with BD and 50 healthy controls were included. Patients were categorized as having high psychosocial functioning if they concomitantly met three conditions: a) General Assessment of Functioning greater than 90, b) full-time employment, and c) full functional recovery. Clinical, demographical, and neurocognitive variables were assessed and considered as potential predictors of high functioning in regression models. We found that 22.8% (n = 33) of patients exhibited high psychosocial functioning. BD type II, higher educational level, and better performance in verbal memory, attention, and executive functions were independent predictors of high psychosocial functioning. Our results provide evidence that functional outcomes are heterogeneous in BD, including a percentage of patients who maintain good to excellent psychosocial functioning despite their illness. Neurocognitive functioning could be one of the most influential factors to explain this heterogeneity.

Heterogeneity of psychosocial functioning in patients with bipolar disorder: Associations with sociodemographic, clinical, neurocognitive and biochemical variables

“…Therefore, a relative big sample and large age span sample of patients with bipolar disorder are needed in further studies. Results from Pearson partial correlation showed that executive function, working and visual memory did moderately correlated with functional domains which is consistent with one previous research ( 14 ). However, there still exists controversies about which neurocognitive domains could explain the heterogeneity of functional outcomes ( 57 ).…”

“…Burdick et al provided empirical evidence on significant heterogeneity of neurocognition in patients with BD, and three different neurocognitive subgroups were found, meanwhile, the demographic and clinical characteristics were different among these subgroups ( 12 ), which was consistent with the other study ( 13 ). And evidence suggests that heterogeneity of psychosocial functioning in BD might exist, which was based on the same or even better neurocognitive performance as the general population ( 4 , 14 ). In addition, Sole et al first confirmed that in euthymic patients with BD also existed three different functional subgroups based on the Functioning Assessment Short Test ( FAST ) domain scores, and three groups have been reported as low functioning group (LF), intermediate functioning group (MF) and good functioning group (GF) ( 15 ).…”

“…Neurocognitive impairment has been demonstrated to be a key predictor of poor functional outcomes ( 21 , 22 ), which is highly related to functional deficits in patients with BD ( 23 ). Especially, the executive function, verbal memory and attention were considered as predictors of good psychosocial functioning ( 14 ). In addition, our previous research and other studies have revealed that cognitive reserve plays an important role between neurocognitive functioning and psychosocial functioning ( 8 , 24 ).…”

The relations between executive functions and occupational functioning in individuals with bipolar disorder: a scoping review

“…Occupational functioning was defined in 23 of the 82 included papers (Wingo et al 2010;Gilbert and Marwaha 2013;Martinez-Aran et al 2007;Depp et al 2012b;Tse et al 2014;Lomastro et al 2020;Altshuler et al 2007;Bello 2009;Bonnin et al 2014;Bowie et al 2010;Deckersbach et al 2010;Drakopoulos et al 2020;Duarte et al 2016;Harvey et al 2010;Levy et al 2013;Luo et al 2020;Mur et al 2008;Sanchez-Moreno et al 2009;Solé et al 2018;Strassnig et al 2017;Tabarés-Seisdedos et al 2008;Torrent et al 2007;Wilder-Willis 2001). We have categorized the definitions regarding the two aspects of occupational functioning mentioned in the introduction: work participation and work functioning.…”

Real-World Functioning in Psychiatric Outpatients: Predictive Factors

“…Moreover, the presence of subsyndromal depressive symptoms represents one of the main predictors of functional impairment, in particular of attitudes such as giving up and self-blame [ 32 , 39 , 40 , 41 ]. Recent papers focused specifically on neurocognitive function [ 27 , 28 , 30 , 42 , 43 ], as cognitive deficits were considered one of the main determinants of functional impairment, and evidence showed that better performance in some areas, such as attention, executive functions, and verbal memory, are predictors of better psychosocial functioning [ 44 ].…”