Previous bipolar disorder episodes exacerbate functional disability
MedWire News: Among bipolar disorder patients living in the community, previous manic episodes appear to impair disability at work and in family life, whereas previous depressive episodes seem to impact on social life disability, study results show.
Reporting their findings in the journal Psychiatry Research, Luis Gutiérrez-Rojas (University of Granada, Spain) and colleagues say that "clinicians should make every effort to prevent relapses, to efficiently treat residual symptoms, and to enhance the social support of these patients."
In the 2004 Global Burden of Disease study, bipolar disorder was reported to be the seventh and eighth leading cause of years lived with a disability for men and women, respectively.
To investigate mediators of this disability in work, social, and family life, the researchers interviewed 108 outpatients with bipolar disorder regarding previous course-of-illness and current psychopathology.
Work disability was defined as being on a disability pension or in the process of obtaining it; while social life or family life disability was defined by a score of 7 or less in the respective subscales of the Sheehan Disability Scale.
At least one type of disability (work, social, family) affected around half of the patients while two types affected 37%.
Work disability was significantly associated with previous repeated manic episodes, three or more hospitalizations, and current depressive symptoms, and inversely associated with education.
Social life disability significantly increased with the number of hospitalisations, previous repeated depressive episodes, and current depressive symptoms.
Current nicotine dependence and lack of social support were also significantly associated with work and social life disability, respectively.
Family life disability significantly increased with the number of hospitalizations, previous repeated manic episodes, and current depressive symptoms.
"This study shows that disability affects an important proportion of bipolar disorder patients and that previous course-of-illness variables, particularly a high number of manic episodes, and current psychopathology - as indicated by the presence of nicotine dependence or depressive symptoms - may be indicators of disability," Gutiérrez-Rojas and colleagues conclude.
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By Andrew Czyzewski