Functional recovery in bipolar disorder linked to marriage, education
MedWire News: Less than half of patients with bipolar disorder achieve functional recovery, report researchers who note that married patients, those with greater education, and those with fewer years of illness are more likely to recover.
“Psychosocial and occupational impairments in patients diagnosed with bipolar disorder are highly prevalent despite modern therapeutic advances,” Aliza Wingo (Emory University, Atlanta, Georgia, USA) and co-authors comment in the journal Bipolar Disorders.
“An important question is what factors might facilitate or impede functional recovery of bipolar disorder patients, particularly considering those in or near symptomatic recovery.”
To investigate they assessed 65 euthymic or residually depressed bipolar disorder patients with the Residential Status Index (RSI) and Vocational Status Index (VSI), adapted from the McLean-Harvard First-Episode project.
In all, 28 (43%) patients achieved functional recovery, defined as regaining individual premorbid or previous highest level of residential and occupational status within a year.
Wingo et al report that patients were more likely to achieve functional recovery if they had more education (odds ratio[OR]=1.45 for each addition year) or were married (OR=4.27); by contrast, longer illness duration decreased the likelihood of functional recovery (OR=0.95 for each additional illness year).
The results remained significant after controlling for residual depressive symptoms, diagnostic type (I versus II), and psychiatric comorbidity.
Functionally unrecovered bipolar disorder patients were more likely to be taking antidepressants than recovered patients (68% versus 27%) and to have mild residual depressive symptoms (22% versus 4%). These differences were not significant, however.
Fewer bipolar II disorder than bipolar I disorder patients attained functional recovery (35% versus 48%), although with the relatively small samples involved, this difference was not statistically significant.
“This comparison adds to growing evidence that bipolar II disorder patients do not have a lesser illness, but rather one marked by more time in depressive states, with similar risks of both suicide and disability as in bipolar disorder,” Wingo et al remark.
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By Andrew Czyzewski