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Meta-Analysis
. 2020 Sep;22(6):569-581.
doi: 10.1111/bdi.12904. Epub 2020 Apr 20.

Functioning in euthymic patients with bipolar disorder: A systematic review and meta-analysis using the Functioning Assessment Short Test

Gabriela Léda-Rêgo  1   2 , Severino Bezerra-Filho  1   2 , Ângela Miranda-Scippa  1   2   3
Affiliations
Meta-Analysis

Functioning in euthymic patients with bipolar disorder: A systematic review and meta-analysis using the Functioning Assessment Short Test

Gabriela Léda-Rêgo et al. Bipolar Disord. 2020 Sep.

Abstract

Objectives: Systematically review the prevalence of functional impairment (FI) in euthymic patients with bipolar disorder (BD), as assessed only with the Functioning Assessment Short Test (FAST), explore the prevalence of this impairment among all the domains, identify the most compromised of them and the clinical variables associated with low functioning in this population.

Methods: Meta-analyses were performed, searching for relevant papers published from 2007 to 2019 in Medline, Embase, Cochrane, PsycINFO databases and via hand-searching, without language restrictions. 1128 studies were initially identified, 13 of which were ultimately chosen based on the eligibility criteria. A two-step meta-analysis was performed using the mean difference with a 95% confidence interval for continuous variables and proportion estimation with a fixed-effects model for categorical variables.

Results: In the first step, all FAST domains showed worse FI in patients than in healthy controls, with significant differences between groups. In the second step, the prevalence of FI domains were as follows: global, 58.6%; occupational, 65.6%; cognitive, 49.2%; autonomy, 42.6%; interpersonal relationships, 42.1%; leisure, 29.2%; and financial issues, 28.8%. Residual depressive symptoms were the most frequently cited variable associated with FI.

Conclusions: This study reinforces the relevant functional impact of BD in this population and suggests that the occupational domain may be the most impaired. Greater efforts should be directed toward targeting functioning in patient care, as it constitutes the most meaningful endpoint of response to treatment, especially with occupational and cognitive rehabilitation, thus allowing patients to overcome the course of illness and carry fulfilling lives.

Keywords: bipolar disorder; euthymia; functional impairment; functioning; meta-analyses; systematic review.

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References

REFERENCES

    1. Grande I, Berk M, Birmaher B, Vieta E. Bipolar disorder. Lancet. 2016;6736(15):1-12.
    1. Merikangas KR, Jin R, He J, et al. Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Arch Gen Psychiatry. 2012;68(3):241-251.
    1. Sanchez-Moreno J, Martinez-Aran A, Tabarés-Seisdedos R, Torrent C, Vieta E, Ayuso-Mateos JL. Functioning and disability in bipolar disorder: an extensive review. Psychother Psychosom. 2009;78:285-297.
    1. Greenberg S, Rosenblum KL, Mcinnis MG, Muzik M. The role of social relationships in bipolar disorder: a review. Psychiatry Res. 2014;219(2):248-254.
    1. Dickinson T, Becerra R, Coombes J. Executive functioning deficits among adults with bipolar disorder (types I and II): a systematic review and meta-analysis. J Affect Disord. 2017;218:407-427.