Introduction: Bipolar disorder represents a chronic and recurrent illness which can lead to severe disruptions in family, social and occupational functioning. Mood symptoms have been associated with functional impairment in bipolar patients. However, the majority of studies have assessed overall functioning without considering specific areas of functional impairment. The current study was conducted to compare the level of functioning in bipolar patients with hypo(mania), depression, euthymia (remission) and healthy controls, by using an standardized scale developed for bipolar disorder.
Methods: The sample included 131 subjects with bipolar disorder (68 in remission, 31 hypo(manic), and 32 depressed), and 61 healthy controls. The Functioning Assessment Short Test (FAST) was used to assess overall disability and multiple areas of functional impairment such as autonomy, occupational functioning, cognitive functioning, interpersonal relationships, financial issues and leisure time.
Results: Significant differences were found across the groups (p<0•001). The higher overall functional impairment was observed in patients who had a depressive episode (48•03±12•38), followed by the patients with an (hypo)manic episode (39•81±13•99), and finally the euthymic group (11•76±12•73). Compared with the healthy control group (5•93±4•43), euthymic patients showed a poorer psychosocial functioning.
Conclusions: This study shows that depression rather than mania has a direct and negative impact on functioning, and the deficits appear to persist during remission. It highlights the importance of treating aggressively both mania and depression, and also suggests the need to develop psychosocial interventions aimed to improve functional outcome.