Neurocognitive and symptomatic predictors of functional outcome in bipolar disorders: a prospective 1 year follow-up study.

BACKGROUND

The aim of this study was to estimate the predictive value of cognitive impairments and time spent ill in long-term functional outcome of patients with bipolar disorder (BD).

METHODS

Thirty five patients with euthymic BD completed a neurocognitive battery to assess verbal memory, attention, and executive functions at study entry. The course of illness was documented prospectively for a period longer than 12 months using a modified life charting technique based on the NIMH life-charting method. Psychosocial functioning was assessed with the General Assessment of Functioning (GAF) and the Functioning Assessment Short Test (FAST) at the end of follow-up period when patients were euthymic.

RESULTS

Impairments in verbal memory and in attention, as well as subsyndromal depressive symptomatology were independent predictors of GAF score at the end of the study explaining 43% of variance. Similarly, impairments in attention and executive functioning were independent predictors of FAST score explaining 28% of variance.

LIMITATIONS

We did not control factors that could affect functional outcome such as psychosocial interventions, familiar support and housing and financial resources.

CONCLUSIONS

Both cognitive impairments and time spent with subsyndromal depressive symptomatology may be illness features associated with poorer long-term functional outcome. Developing strategies to treat these illness features might contribute to enhance long-term functional outcome among patients with BD.