4.7 Article

Long-term outcome predictors after functional remediation in patients with bipolar disorder

Journal

PSYCHOLOGICAL MEDICINE
Volume 52, Issue 2, Pages 314-322

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291720001968

Keywords

Bipolar disorder; cognition; cognitive remediation; functional remediation; functioning

Funding

  1. Spanish Ministry of Science, Universities and Innovation
  2. CIBER of Mental Health (CIBERSAM)
  3. Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement [2017 SGR 1365]
  4. CERCA Programme/Generalitat de Catalunya
  5. Departament de Salut de la Generalitat de Catalunya [SLT002/16/00331]
  6. Spanish Ministry of Economy and Competitiveness, Instituto de Salud Carlos III through a 'Rio Hortega' contract [CM17/00102]
  7. Spanish Ministry of Economy and Competitiveness, Instituto Carlos III, through a 'Miguel Servet' postdoctoral contract [CPI14/00175]
  8. Spanish Ministry of Economy and Competitiveness, Instituto Carlos III, through Miguel Servet II [CPII19/00018]
  9. Instituto de Salud Carlos III [PI15/00330, PI17/01066]
  10. European Regional Development Fund ('Investing in your future')
  11. CERCA (Programme/Generalitat de Catalunya) [SLT006/17/00357, SLT 006/17/00352]

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The study found that patients with better cognitive performance, particularly in terms of verbal memory and executive functions at baseline, are likely to have better functional outcomes in the long-term follow-up after receiving functional remediation for bipolar disorder.
Background Improving functioning in patients with bipolar disorder (BD) is one of the main objectives in clinical practice. Of the few psychosocial interventions that have been specifically developed to enhance the psychosocial outcome in BD, functional remediation (FR) is one which has demonstrated efficacy. The aim of this study was to examine which variables could predict improved functional outcome following the FR intervention in a sample of euthymic or subsyndromal patients with BD. Methods A total of 92 euthymic outpatients were included in this longitudinal study, with 62 completers. Partial correlations controlling for the functional outcome at baseline were calculated between demographic, clinical and neurocognitive variables, and functional outcome at endpoint was assessed by means of the Functioning Assessment Short Test scale. Next, a multiple regression analysis was run in order to identify potential predictors of functional outcome at 2-year follow-up, using the variables found to be statistically significant in the correlation analysis and other variables related to functioning as identified in the previous scientific literature. Results The regression model revealed that only two independent variables significantly contributed to the model (F-(6,F-53): 4.003; p = 0.002), namely verbal memory and inhibitory control. The model accounted for 31.2% of the variance. No other demographic or clinical variable contributed to the model. Conclusions Results suggest that patients with better cognitive performance at baseline, especially in terms of verbal memory and executive functions, may present better functional outcomes at long term follow-up after receiving functional remediation.

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