Predictors of Functional Impairment in Bipolar Disorder: Results from 13 Cohorts from Seven Countries by The Global Bipolar Cohort Collaborative
K. Burdick
(1)
,
C. Millett
(1)
,
A. Yocum
(2)
,
C. Altimus
(3)
,
O. Andreassen
(4)
,
V. Aubin
(5)
,
R. Belzeaux
(6, 7)
,
M. Berk
(8, 9)
,
J. Biernacka
(10)
,
H. Blumberg
(11)
,
A. Cleare
(12)
,
C. Diaz‐byrd
(2)
,
C. Dubertret
(13, 14)
,
B. Etain
(15, 16)
,
L. Eyler
(17)
,
B. Forester
(18)
,
J. Fullerton
(19)
,
M. Frye
(10)
,
S. Gard
(20)
,
O. Godin
(21, 22, 23)
,
E. Haffen
(24)
,
F. Klaus
(17)
,
T. Lagerberg
(4)
,
M. Leboyer
(21, 22, 23)
,
A. Martinez‐aran
(25)
,
S. Mcelroy
(26)
,
P. Mitchell
(19)
,
Émilie Olié
(27, 28)
,
P. Olorunfemi
(29)
,
C. Passerieux
(30, 31)
,
A. Peters
(29)
,
D. Pham
(3)
,
M. Polosan
(32, 33)
,
J. Potter
(1)
,
M. Sajatovic
(34)
,
L. Samalin
(35, 36)
,
R. Schwan
(37)
,
M. Shanahan
(1)
,
B. Solé
(25)
,
R. Strawbridge
(12)
,
A. Stuart
(8)
,
I. Torres
(38)
,
T. Ueland
(4, 39)
,
E. Vieta
(25)
,
L. Williams
(8, 40)
,
A. Wrobel
(8, 9)
,
L. Yatham
(38)
,
A. Young
(12)
,
A. Nierenberg
(29)
,
M. Mcinnis
(2)
1
HMS -
Harvard Medical School [Boston]
2 University of Michigan [Ann Arbor]
3 Milken Institute School of Public Health
4 NORMENT - Norwegian Centre for Mental Disorders Research [Oslo]
5 Centre Hospitalier Princesse Grace
6 APHM - Assistance Publique - Hôpitaux de Marseille
7 INT - Institut de Neurosciences de la Timone
8 Deakin University [Burwood]
9 Orygen Youth Health Research Centre [Melbourne]
10 Mayo Clinic [Rochester]
11 YSM - Yale School of Medicine [New Haven, Connecticut]
12 King‘s College London
13 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
14 Hôpital Louis Mourier - AP-HP [Colombes]
15 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
16 Hôpital Lariboisière-Fernand-Widal [APHP]
17 UC San Diego - University of California [San Diego]
18 McLean Hospital [Belmont, Ma.]
19 UNSW - University of New South Wales [Sydney]
20 Centre hospitalier Charles Perrens [Bordeaux]
21 IMRB - Institut Mondor de Recherche Biomédicale
22 CHU Henri Mondor [Créteil]
23 Fondation FondaMental [Créteil]
24 UBFC - Université Bourgogne Franche-Comté [COMUE]
25 CIBER-SAM - Centro de Investigación Biomédica en Red Salud Mental [Madrid]
26 University of Cincinnati College of Medicine
27 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
28 IGF - Institut de Génomique Fonctionnelle
29 Massachusetts General Hospital [Boston]
30 CHV - Centre Hospitalier de Versailles André Mignot
31 CESP - Centre de recherche en épidémiologie et santé des populations
32 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
33 GIN - [GIN] Grenoble Institut des Neurosciences
34 Case Western Reserve University [Cleveland]
35 CHU Clermont-Ferrand
36 IP - Institut Pascal
37 UL - Université de Lorraine
38 UBC - University of British Columbia
39 UiO - University of Oslo
40 Barwon Health - IMPACT Strategic Research Centre [VIC, Australia]
2 University of Michigan [Ann Arbor]
3 Milken Institute School of Public Health
4 NORMENT - Norwegian Centre for Mental Disorders Research [Oslo]
5 Centre Hospitalier Princesse Grace
6 APHM - Assistance Publique - Hôpitaux de Marseille
7 INT - Institut de Neurosciences de la Timone
8 Deakin University [Burwood]
9 Orygen Youth Health Research Centre [Melbourne]
10 Mayo Clinic [Rochester]
11 YSM - Yale School of Medicine [New Haven, Connecticut]
12 King‘s College London
13 IPNP - U1266 Inserm - Institut de psychiatrie et neurosciences de Paris
14 Hôpital Louis Mourier - AP-HP [Colombes]
15 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
16 Hôpital Lariboisière-Fernand-Widal [APHP]
17 UC San Diego - University of California [San Diego]
18 McLean Hospital [Belmont, Ma.]
19 UNSW - University of New South Wales [Sydney]
20 Centre hospitalier Charles Perrens [Bordeaux]
21 IMRB - Institut Mondor de Recherche Biomédicale
22 CHU Henri Mondor [Créteil]
23 Fondation FondaMental [Créteil]
24 UBFC - Université Bourgogne Franche-Comté [COMUE]
25 CIBER-SAM - Centro de Investigación Biomédica en Red Salud Mental [Madrid]
26 University of Cincinnati College of Medicine
27 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
28 IGF - Institut de Génomique Fonctionnelle
29 Massachusetts General Hospital [Boston]
30 CHV - Centre Hospitalier de Versailles André Mignot
31 CESP - Centre de recherche en épidémiologie et santé des populations
32 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
33 GIN - [GIN] Grenoble Institut des Neurosciences
34 Case Western Reserve University [Cleveland]
35 CHU Clermont-Ferrand
36 IP - Institut Pascal
37 UL - Université de Lorraine
38 UBC - University of British Columbia
39 UiO - University of Oslo
40 Barwon Health - IMPACT Strategic Research Centre [VIC, Australia]
K. Burdick
- Fonction : Auteur
- PersonId : 824233
- ORCID : 0000-0003-4417-4988
C. Millett
- Fonction : Auteur
- PersonId : 824193
- ORCID : 0000-0003-0072-5522
J. Biernacka
- Fonction : Auteur
- PersonId : 805585
- ORCID : 0000-0001-9350-4440
H. Blumberg
- Fonction : Auteur
- PersonId : 805586
- ORCID : 0000-0002-6363-4698
B. Etain
- Fonction : Auteur
- PersonId : 757741
- IdHAL : bruno-etain
- ORCID : 0000-0002-5377-1488
- IdRef : 074181106
J. Fullerton
- Fonction : Auteur
- PersonId : 792529
- ORCID : 0000-0003-4014-4490
Émilie Olié
- Fonction : Auteur
- PersonId : 975700
A. Peters
- Fonction : Auteur
- PersonId : 755326
- ORCID : 0000-0003-0224-647X
J. Potter
- Fonction : Auteur
- PersonId : 755340
- ORCID : 0000-0002-4679-0269
M. Sajatovic
- Fonction : Auteur
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- ORCID : 0000-0002-3073-668X
R. Strawbridge
- Fonction : Auteur
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- ORCID : 0000-0002-2984-1124
T. Ueland
- Fonction : Auteur
E. Vieta
- Fonction : Auteur
- PersonId : 785945
- ORCID : 0000-0003-1673-8248
L. Williams
- Fonction : Auteur
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- ORCID : 0000-0002-1377-1272
A. Wrobel
- Fonction : Auteur
- PersonId : 824237
- ORCID : 0000-0002-1864-0394
A. Nierenberg
- Fonction : Auteur
- PersonId : 807097
- ORCID : 0000-0003-2897-0458
Résumé
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=5,882 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 41-75%. 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, 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.
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