Fewer 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,” Emory University psychiatrist Aliza Wingo 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.”
Wingo and colleagues assessed 65 euthymic (normal mood) 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 percent) 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 additional 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 percent versus 27 percent) and to have mild residual depressive symptoms (22 percent versus 4 percent). These differences were not significant, however.
Fewer bipolar II disorder than bipolar I disorder patients attained functional recovery (35 percent versus 48 percent), 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.
Source: Medwire News