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Focus: Journal of Life Long Learning in Psychiatry logoLink to Focus: Journal of Life Long Learning in Psychiatry
. 2023 Oct 15;21(4):444–452. doi: 10.1176/appi.focus.23021021

Predictors of Functional Impairment in Bipolar Disorder: Results From 13 Cohorts From Seven Countries by the Global Bipolar Cohort Collaborative

Katherine E Burdick 1,, Caitlin E Millett 1, Anastasia K Yocum 1, Cara M Altimus 1, Ole A Andreassen 1, Valerie Aubin 1, Raoul Belzeaux 1, Michael Berk 1, Joanna M Biernacka 1, Hilary P Blumberg 1, Anthony J Cleare 1, Claudia Diaz-Byrd 1, Caroline Dubertret 1, Bruno Etain 1, Lisa T Eyler 1, Brent P Forester 1, Janice M Fullerton 1, Mark A Frye 1, Sébastien Gard 1, Ophelia Godin 1, Emmanuel Haffen 1, Federica Klaus 1, Trine Vik Lagerberg 1, Marion Leboyer 1, Anabel Martinez-Aran 1, Susan McElroy 1, Philip B Mitchell 1, Emilie Olie 1, Phebe Olorunfemi 1, Christine Passerieux 1, Amy T Peters 1, Daniel L Pham 1, Mircea Polosan 1, Julia R Potter 1, Martha Sajatovic 1, Ludovic Samalin 1, Raymund Schwan 1, Megan Shanahan 1, Brisa Solé 1, Rebecca Strawbridge 1, Amanda L Stuart 1, Ivan Torres 1, Torrill Ueland 1, Eduard Vieta 1, Lana J Williams 1, Anna L Wrobel 1, Lakshmi N Yatham 1, Allan H Young 1, Andrew A Nierenberg 1, Melvin G McInnis 1
PMCID: PMC11058953  PMID: 38694997

Abstract

Objectives:

Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD.

Methods:

Thirteen cohorts from 7 countries included n = 5882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived “higher versus lower function” as the dependent variable and selected clinical and demographic variables as predictors.

Results:

We found high rates of functional impairment, ranging from 41 to 75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, the presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning.

Conclusions:

The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients' complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.

Reprinted from Bipolar Disord 2022; 24:709–719, with permission from John Wiley and Sons. Copyright © 2022


Articles from Focus: Journal of Life Long Learning in Psychiatry are provided here courtesy of American Psychiatric Publishing

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