Manic morbidity and executive function impairment as determinants of long‐term psychosocial dysfunction in bipolar disorder

LOMASTRO, MARÍA JULIETA; VALERIO, MARINA P.; SZMULEWICZ, ALEJANDRO G.; MARTINO, DIEGO J.

ACTA PSYCHIATRICA SCANDINAVICA

WILEY-BLACKWELL PUBLISHING, INC

Año: 2021 vol. 144 p. 72 - 81

0001-690X

Objective: In this study, we aimed to evaluate the role of cognitive performance and measures of clinical course?including both syndromal and subsyndromal symptom- atology?as determinants of the functional outcome of patients with Bipolar Disorder (BD) during a mean follow-up period of more than 4 years.Methods: Seventy patients with euthymic BD completed a neurocognitive battery at study entry. Clinical course was assessed prospectively for a period longer than 48 months by two measures: time spent ill (documented using a modified life charting technique) and density of affective episodes (defined as the number of depressive and hypo/manic episodes per year of follow-up). Psychosocial functioning was assessed during euthymia using the Functioning Assessment Short Test (FAST) total score at the end of follow-up period.Results: Baseline deficits in phonological fluency, a measure of executive functions (β = −2.49; 95% CI = −3.98, −0.99), and density of hypo/manic episodes during fol- low-up (β = 6.54; 95% CI = 0.43, 12.65) were independently associated with FAST total score at the end of study.Conclusions: Although interrelated, manic morbidity and executive function impair- ments independently contribute to long-term psychosocial dysfunction in BD and could be potential targets of intervention.