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Vol. 78, No. 5, 2009
Issue release date: August 2009
Section title: Special Article
Psychother Psychosom 2009;78:285–297
(DOI:10.1159/000228249)

Functioning and Disability in Bipolar Disorder: An Extensive Review

Sanchez-Moreno J. · Martinez-Aran A. · Tabarés-Seisdedos R. · Torrent C. · Vieta E. · Ayuso-Mateos J.L.
aBipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, IDIBAPS, and bBipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic of Barcelona, CIBERSAM, IDIBAPS, University of Barcelona, Barcelona, cDepartment of Psychiatry, Universidad Autónoma de Madrid, Hospital Universitario de la Princesa, CIBERSAM, Madrid, d Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, and eCommittee on Functionality and Disability of the International Society for Bipolar Disorders, Barcelona, Spain

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Article / Publication Details

First-Page Preview
Abstract of Special Article

Received: 6/5/2008
Accepted: 10/17/2008
Published online: 7/11/2009

Number of Print Pages: 13
Number of Figures: 0
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

Background: Bipolar disorder has generally been regarded as having a better functional outcome than schizophrenia. However, studies have suggested low functioning in bipolar patients even when they are in clinical remission. Our aim was to determine the degree of functioning and disability in bipolar patients. Secondly, we reviewed factors potentially associated with the low functioning of bipolar patients. Method: The authors conducted an extensive Medline and Pubmed search of the published literature from 1980 up to December 2007, using a variety of search terms to find relevant articles. Bibliographies of retrieved papers were further analysed for publications of interest. Articles that reported clinically significant findings on functioning and disability, and research reports were reviewed in detail. Results: From these articles, we determined that bipolar disorder is associated with significant impairment in work, family and social life, beyond the acute phases of the illness. The aspects that appear to increase the risk of low functioning and disability in bipolar patients are mainly subsyndromal symptoms and neurocognitive impairment, among others. Conclusions: Suitable pharmacological and psychological interventions may improve the level of functioning and reduce the disability in bipolar patients. Potential targets to be considered for intervention should be residual symptoms, comorbid conditions and neurocognitive deficits. Further research is required to better identify the factors that best predict functioning in bipolar patients.


Article / Publication Details

First-Page Preview
Abstract of Special Article

Received: 6/5/2008
Accepted: 10/17/2008
Published online: 7/11/2009

Number of Print Pages: 13
Number of Figures: 0
Number of Tables: 2

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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