Serra-Navarro Maria, Clougher Derek, Solé Brisa, Sánchez-Moreno Jose, González-Pinto Ana, Jiménez Esther, Amann Benedikt L, Balanzá-Martínez Vicent, Tabarés-Seisdedos Rafael, Arango Celso, Accardo Vivian, García-Portilla María Paz, Ibáñez Ángela, Crespo José Manuel, Ayuso-Mateos José Luis, Amoretti Silvia, Torrent Carla, Martínez-Aran Anabel, Vieta Eduard
Bipolar and Depressive Disorders Unit, Department of Psychiatry and Psychology, Hospital Clinic of Barcelona, Barcelona, Spain.
Fundació Clínic per la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi i Sunyer (FCRB-IDIBAPS), Barcelona, Spain.
Acta Psychiatr Scand. 2024 Dec;150(6):543-561. doi: 10.1111/acps.13748. Epub 2024 Sep 7.
Functional recovery remains a core clinical objective for patients with bipolar disorder (BD). Sociodemographic, clinical, and neurocognitive variables are associated with long-term functional impairment, yet the impact of sex differences is unclear. Functional remediation (FR) is a validated intervention aimed at achieving functional recovery in BD. The present study assessed the effect of sex differences of FR on psychosocial functioning at post-treatment (6-months) and 12-month follow-up (FUP). To the best of our knowledge, this is the first study to explore the role of sex as a factor in the efficacy of FR.
157 participants with BD were randomly assigned to either FR (N = 77) or treatment as usual group (80). Clinical, sociodemographic, neuropsychological, and functional data were obtained using a comprehensive assessment battery. Sex differences were explored via a general linear model (GLM) for repeated measures to compare the effect of sex on the intervention over time (6 months and FUP).
Results demonstrated that FR benefits both sexes, males (p = 0.001; d' = 0.88) and females (p = 0.04; d' = 0.57), at 6 months suggesting a generalized functional improvement. Conversely, at 12-month FUP sex differences were observed only in males (p = 0.005; d' = 0.68).
FR is a beneficial intervention for males and females after treatment, suggesting that there are no relevant distinct needs. Females may benefit from ongoing psychosocial functioning booster sessions after the intervention to maintain original improvements. Future research exploring sex differences could help to identify strategies to offer personalized FR intervention approaches in individuals with BD.
功能恢复仍是双相情感障碍（BD）患者的核心临床目标。社会人口统计学、临床和神经认知变量与长期功能损害相关，但性别差异的影响尚不清楚。功能修复（FR）是一种经过验证的干预措施，旨在实现BD患者的功能恢复。本研究评估了FR的性别差异对治疗后（6个月）和12个月随访时心理社会功能的影响。据我们所知，这是第一项探讨性别作为FR疗效因素作用的研究。
157名BD患者被随机分配至FR组（N = 77）或常规治疗组（80名）。使用综合评估工具获取临床、社会人口统计学、神经心理学和功能数据。通过重复测量的一般线性模型（GLM）探索性别差异，以比较性别对不同时间（6个月和随访）干预效果的影响。
结果表明，FR对男女两性均有益，在6个月时男性（p = 0.001；d' = 0.88）和女性（p = 0.04；d' = 0.57）均显示出功能普遍改善。相反，在12个月随访时，仅在男性中观察到性别差异（p = 0.005；d' = 0.68）。
FR对治疗后的男性和女性都是有益的干预措施，表明不存在相关的明显差异需求。女性可能在干预后受益于持续的心理社会功能强化训练，以维持最初的改善效果。未来探索性别差异的研究有助于确定为BD患者提供个性化FR干预方法的策略。
