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Functioning in euthymic patients with bipolar disorder: A systematic review and meta-analysis using the Functioning
Gabriela Léda-Rêgo1,2, Severino Bezerra-Filho1,2, Ângela Miranda-Scippa1,2,3
1Mood and Anxiety Disorders Program (CETHA), Federal University of Bahia (UFBA), Salvador, Brazil.
Bipolar Disorders
|April 4, 2020
Summary
Functional impairment is common in euthymic bipolar disorder (BD) patients, particularly in occupational domains. Addressing these functional deficits through rehabilitation is crucial for improving patient outcomes and quality of life.
Area of Science:
- Neuroscience
- Psychiatry
- Clinical Psychology
Background:
- Bipolar disorder (BD) significantly impacts daily functioning, even during euthymic phases.
- The Functioning Assessment Short Test (FAST) is a key tool for evaluating functional impairment (FI).
- Understanding FI prevalence and associated factors is vital for effective treatment strategies.
Purpose of the Study:
- To systematically review the prevalence of functional impairment (FI) in euthymic bipolar disorder (BD) patients using the FAST.
- To explore FI across all FAST domains and identify the most affected areas.
- To identify clinical variables associated with low functioning in this population.
Main Methods:
- A systematic review and meta-analysis of studies published between 2007 and 2019.
- Inclusion of 13 studies from a pool of 1128 identified papers.
- Two-step meta-analysis using fixed-effects models for continuous and categorical variables.
Main Results:
- All FAST domains demonstrated significantly worse FI in BD patients compared to healthy controls.
- Prevalence of FI: global (58.6%), occupational (65.6%), cognitive (49.2%), autonomy (42.6%), interpersonal (42.1%), leisure (29.2%), and financial (28.8%).
- Residual depressive symptoms were the most frequently cited variable linked to FI.
Conclusions:
- Functional impairment, especially in the occupational domain, is a significant issue for euthymic BD patients.
- Targeting functioning in patient care, including occupational and cognitive rehabilitation, is essential.
- Improving functional outcomes can lead to more fulfilling lives for individuals with BD.
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