Neurocognitive and symptomatic predictors of functional outcome in bipolar disorders: A prospective 1 year follow-up study

Background: The aim of this study was to estimate the predictive value of cognitive impairments and time spent ill in long-term functional outcome of patients with bipolar disorder (BD). Methods: Thirty five patients with euthymic BD completed a neurocognitive battery to assess verbal memory, attention, and executive functions at study entry. The course of illness was documented prospectively for a period longer than 12 months using a modified life charting technique based on the NIMH life-charting method. Psychosocial functioning was assessed with the General Assessment of Functioning (GAF) and the Functioning Assessment Short Test (FAST)at the end of follow-up period when patients were euthymic. Results: Impairments in verbal memory and in attention, as well as subsyndromal depressive symptomatology were independent predictors of GAF score at the end of the study explaining 43% of variance. Similarly, impairments in attention and executive functioning were independent predictors of FAST score explaining 28% of variance. Limitations: We did not control factors that could affect functional outcome such as psychosocial interventions, familiar support and housing and financial resources. Conclusions: Both cognitive impairments and time spent with subsyndromal depressive symptomatology may be illness features associated with poorer long-term functional outcome. Developing strategies to treat these illness features might contribute to enhance long-term functional outcome among patients with BD. (C) 2008 Elsevier B.V. All rights reserved.