Department of Psychiatry, Hospital Virgen de La Luz, CIBERSAM, Cuenca, Spain; Neurobiological Research Group. Institute of Technology, Universidad de Castilla-La Mancha, Cuenca, Spain.
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBERSAM, Madrid, Spain; CogPsy-Group, Universidad Complutense de Madrid (UCM), Spain.
J Affect Disord. 2020 Jul 1;272:249-258. doi: 10.1016/j.jad.2020.03.140. Epub 2020 Apr 30.
Functional impairment is commonly encountered among patients with bipolar disorder (BD) during periods of remission. The distribution of the impairment of the functional outcome is heterogeneous. The objective of this current investigation was to identify neurocognitive and clinical predictors of psychosocial functioning in a sample of patients with BD.
Seventy-six patients (59.2% females) and 40 healthy controls (50% females), aged 18 to 55 years, were assessed using a comprehensive neurocognitive battery (six neurocognitive domains), and the Functioning Assessment Short Test (FAST), at baseline and after a 5-year follow-up. Stepwise regression models were used to identify predictor variables related to psychosocial functioning.
The number of hospitalizations during the follow-up, the change occurred in the neurocognitive composite index (NCI change), and NCI at baseline explained 30.8% of the variance of functioning. The number of hospitalizations during the follow-up was the variable that explained a greater percentage of the variance (16.9%). Verbal memory at baseline and the change in sustained attention during the follow-up explained 10% and 5.9% of the variance of the psychosocial functioning, respectively.
The interval of 5 years between the two assessments could be too short to detect a possible progression in functional outcome for the overall sample.
The clinical course during the follow-up is the factor that has a greater impact on psychosocial functioning in patients with BD. Thus, the interventions aimed to promote prevention of relapses should be considered as essential for avoiding functional impairment in these patients.
在缓解期，双相情感障碍（BD）患者常出现功能障碍。功能结果的损害分布具有异质性。本研究旨在确定双相情感障碍患者样本中神经认知和临床因素与心理社会功能的关系。
对 76 名患者（59.2%为女性）和 40 名健康对照者（50%为女性）进行评估，使用综合神经认知测试（六个神经认知领域）和 FAST（功能评估简短测试），基线和 5 年后随访。使用逐步回归模型确定与心理社会功能相关的预测变量。
随访期间的住院次数、神经认知综合指数（NCI）的变化、以及基线 NCI 解释了 30.8%的功能变化。随访期间的住院次数是解释功能变化的变量，占比 16.9%。基线时的言语记忆和随访期间的持续注意力变化分别解释了心理社会功能的 10%和 5.9%的方差。
两次评估之间的 5 年间隔可能太短，无法检测整个样本的功能结果是否有进展。
随访期间的临床病程是影响双相情感障碍患者心理社会功能的主要因素。因此，旨在预防复发的干预措施应被视为避免这些患者出现功能障碍的重要手段。
