Background:
This study examines the relationship between the presence of inter-episodic symptomatology, the frequency of depressed and (hypo)manic episodes, and impairment across eight different domains of functioning.
Method:
Patients (n = 217) attending a tertiary referral center for the assessment of bipolar disorder, who met DSM-IV criteria for BP I or BP II disorder, were included in the analysis. Data were collected on 10 common inter-episodic symptoms reflecting both mood and anxiety, and the frequency of depressive and (hypo)manic episodes. Impairment in the following functional domains was also determined: occupation, financial affairs, self-care, housekeeping, intimate and nonintimate relationships, and parenting. Logistic regression analyses were conducted to examine the number of inter-episodic symptoms reported and the frequency of frank bipolar disorder episodes as predictors of impairment in eight domains of psychosocial functioning.
Results:
Psychosocial functional impairment and inter-episodic symptoms were highly prevalent in the sample. The number of inter-episodic symptoms was significantly associated with relationship impairment and employment status, while the frequency of (hypo)manic episodes was associated with impairment in housekeeping and parenting roles. There was no apparent relationship between frequency of depressive episodes and functional capacity.
Conclusions:
Both the ‘dosage’ of inter-episodic (sub-syndromal) symptoms and the frequency of (hypo)manic episodes appear to be significant and independent determinants of psychosocial functioning. It is possible that certain aspects of bipolar disorder have a greater impact on some functional domains. Possible methodological reasons for the failure to show a relationship with the frequency of depressive episodes are discussed.
