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Impaired psychosocial functioning in bipolar disorder: the relative contributions of inter-episodic symptoms and illness episodes

Published online by Cambridge University Press:  24 June 2014

P Mitchell,
G Malhi,
J Ball,
A Johnston,
D Hadzi-Pavlovic and
J Corry
P Mitchell
Affiliation:
School of Psychiatry, University of New South WalesThe Black Dog Institute;
G Malhi
Affiliation:
The Black Dog Institute;Academic Discipline of Psychological Medicine, Northern Clinical School, The University of SydneyPrince of Wales Medical Research Institute, Sydney, Australia
J Ball
Affiliation:
School of Psychiatry, University of New South Wales
A Johnston
Affiliation:
School of Psychiatry, University of New South Wales
D Hadzi-Pavlovic
Affiliation:
School of Psychiatry, University of New South Wales
J Corry
Affiliation:
School of Psychiatry, University of New South Wales
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Abstract

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Information

Type
Abstracts from ‘Brainwaves’— The Australasian Society for Psychiatric Research Annual Meeting 2006, 6–8 December, Sydney, Australia
Information
Acta Neuropsychiatrica , Volume 18 , Issue 6 , December 2006, pp. 262
Copyright
Copyright © 2006 Blackwell Munksgaard

Background:

This study examines the relationship between the presence of inter-episodic symptomatology, the frequency of depressed and (hypo)manic episodes, and impairment across eight different domains of functioning.

Method:

Patients (n = 217) attending a tertiary referral center for the assessment of bipolar disorder, who met DSM-IV criteria for BP I or BP II disorder, were included in the analysis. Data were collected on 10 common inter-episodic symptoms reflecting both mood and anxiety, and the frequency of depressive and (hypo)manic episodes. Impairment in the following functional domains was also determined: occupation, financial affairs, self-care, housekeeping, intimate and nonintimate relationships, and parenting. Logistic regression analyses were conducted to examine the number of inter-episodic symptoms reported and the frequency of frank bipolar disorder episodes as predictors of impairment in eight domains of psychosocial functioning.

Results:

Psychosocial functional impairment and inter-episodic symptoms were highly prevalent in the sample. The number of inter-episodic symptoms was significantly associated with relationship impairment and employment status, while the frequency of (hypo)manic episodes was associated with impairment in housekeeping and parenting roles. There was no apparent relationship between frequency of depressive episodes and functional capacity.

Conclusions:

Both the ‘dosage’ of inter-episodic (sub-syndromal) symptoms and the frequency of (hypo)manic episodes appear to be significant and independent determinants of psychosocial functioning. It is possible that certain aspects of bipolar disorder have a greater impact on some functional domains. Possible methodological reasons for the failure to show a relationship with the frequency of depressive episodes are discussed.