Department of Psychiatry, Hospital Virgen de La Luz CIBERSAM, Cuenca, Spain.
Neurobiological Research Group, Institute of Technology, Universidad de Castilla-La Mancha, Cuenca, Spain.
Eur Arch Psychiatry Clin Neurosci. 2020 Dec;270(8):947-957. doi: 10.1007/s00406-019-01050-9. Epub 2019 Aug 17.
We aimed to examine the trajectory of psychosocial functioning in a sample of euthymic patients with bipolar disorder (BD) throughout a 5-year follow-up. Ninety-nine euthymic bipolar patients and 40 healthy controls (HC) were included. A neurocognitive assessment (17 neurocognitive measures grouped in 6 domains) was carried out at baseline. The split version of the Global Assessment of Functioning scale (GAF-F) and the Functioning Assessment Short Test (FAST) were used to examine psychosocial functioning at baseline (T1), and after a 5-year follow-up (T2). The statistical analysis was performed through repeated measures ANOVA and hierarchical cluster analysis based on the GAF-F and the FAST scores at T1 and T2. Eighty-seven patients (87.9%) were evaluated at T2. The cluster analysis identified two groups of patients. The first group included 44 patients (50.6%) who did not show a progression of the functional impairment (BD-NPI). The second cluster, which included 43 patients (49.4%), was characterized by a progression of the functional impairment (BD-PI). The BD-PI had a higher number of relapses and a higher number of hospitalizations during the follow-up period, as well as worse neurocognitive functioning than the BD-NPI. The repeated measures ANOVA confirmed that the psychosocial performance of BD-NPI is stable while there was a progression of the functional deterioration in BD-PI. The trajectory of the psychosocial functioning of patients with BD is not homogeneous. Our results suggest that in at least one subset of patients with BD, which might account for half of the patients, the disease has a progressive course.
我们旨在研究一组心境稳定的双相情感障碍（BD）患者在 5 年随访期间的心理社会功能轨迹。共纳入 99 例心境稳定的双相情感障碍患者和 40 例健康对照者（HC）。在基线时进行了神经认知评估（17 项神经认知测试分为 6 个领域）。使用全球功能评估量表（GAF-F）的分裂版本和功能评估简短测试（FAST）来评估基线（T1）和 5 年随访后（T2）的心理社会功能。通过重复测量方差分析和基于 GAF-F 和 FAST 在 T1 和 T2 的得分的层次聚类分析来进行统计分析。87 例患者（87.9%）在 T2 时进行了评估。聚类分析确定了两组患者。第一组包括 44 例（50.6%）患者，他们的功能障碍没有进展（BD-NPI）。第二组包括 43 例（49.4%）患者，其功能障碍呈进展趋势（BD-PI）。BD-PI 在随访期间有更多的复发和住院次数，以及更差的神经认知功能，比 BD-NPI。重复测量方差分析证实，BD-NPI 的心理社会表现是稳定的，而 BD-PI 的功能恶化则在进展。BD 患者的心理社会功能轨迹并不均匀。我们的结果表明，在至少一半的患者中，BD 的至少一部分患者的疾病呈进行性病程。
