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Determinants of Functioning in Euthymic Patients with Bipolar Disorder: A Structural Equation Modelling Approach

Published online by Cambridge University Press:  23 March 2020

L. Samalin ,
L. Boyer ,
A. Murru ,
I. Pacchiarotti ,
M. Reinares ,
C.M. Bonnin ,
C. Torrent ,
V. Norma ,
P. Corinna  and
I. de Chazeron
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L. Samalin
Affiliation:
CHU de Clermont-Ferrand, Psychiatry, EA 7280, Clermont-Ferrand, France
L. Boyer
Affiliation:
Aix-Marseille University- EA 3279- Public Health, Chronic Diseases and Quality of Life research Unit, Marseille, France
A. Murru
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain
I. Pacchiarotti
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain
M. Reinares
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain
C.M. Bonnin
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain
C. Torrent
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain
V. Norma
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain
P. Corinna
Affiliation:
Policlinico Umberto I of Rome- La sapienza University of Roma, Department of Neurology and Psychiatry, Roma, Italy
I. de Chazeron
Affiliation:
CHU de Clermont-Ferrand, Psychiatry, EA 7280, Clermont-Ferrand, France
M. Boucekine
Affiliation:
Aix-Marseille University- EA 3279- Public Health, Chronic Diseases and Quality of Life research Unit, Marseille, France
P.A. Geoffroy
Affiliation:
AP–HP–GH Saint-Louis–Lariboisiére–F. Widal, Inserm U1144, université Paris-Diderot, pôle de psychiatrie et de médecine addictologique, Paris, France
F. Bellivier
Affiliation:
AP–HP–GH Saint-Louis–Lariboisiére–F. Widal, Inserm U1144, université Paris-Diderot, pôle de psychiatrie et de médecine addictologique, Paris, France
P.M. Llorca
Affiliation:
CHU de Clermont-Ferrand, Psychiatry, EA 7280, Clermont-Ferrand, France
E. Vieta
Affiliation:
Institute of Neuroscience- Hospital Clinic- University of Barcelona, Bipolar Disorder Unit, Barcelona, Spain

Abstract

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Background

Euthymic patients with bipolar disorder (BD) experience residual symptoms. Interestingly, residual symptoms appear to impact the natural course of BD and represent potential predictors of recurrence and functional impairment.

Objectives

The study aimed to analyse the relationship between residual depressive symptoms, sleep disturbances and cognitive impairment as determinants of psychosocial functioning in a large sample of euthymic BD patients.

Methods

We performed a cross-sectional study of 468 BD outpatients in clinical remission for at least 6 months. Bipolar Depression Rating Scale (BDRS), Pittsburgh Sleep Quality Index (PSQI) scale, Visual Analogic Scales (VAS) evaluated cognitive impairment and functioning assessment short test were used to assess residual symptomatology and functioning of patients. We evaluated functioning with. Structural equation modelling (SEM) was used to describe the relationships among the residual depressive symptoms, sleep disturbances, perceived cognitive performance and functioning.

Results

SEM showed good fit. This model revealed that residual depressive symptoms (path coefficient = 0.37) and perceived cognitive performance (path coefficient = 0.27) were the most important features significantly related to psychosocial functioning. Sleep disturbances were indirectly associated with functioning via residual depressive symptoms and perceived cognitive performance (path coefficient = 0.23).

Conclusions

This study contributes to a better understanding of the determinants of psychosocial functioning during the interepisodic periods of BD patients. These findings should have implications for the improvement of functioning of BD patients in a personalized approach to treatment.

Disclosure of interest

COI: Dr. Samalin reports personal fees and nonfinancial support from Astra-Zeneca, Bristol Myers Squibb, Janssen, Lundbeck, and Otsuka.

The authors L. Boyer, A. Murru, I. Pacchiarotti, M. Reinares, C.M. Bonnin, C. Torrent, V. Norma, P. Corinna, I. de Chazeron, M. Boucekine, P.A. Geoffroy, F. Bellivier, P.M. Llorca, E. Vieta have have not supplied their declaration of competing interest.

Type
Oral communications: Bipolar disorders
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S77
Copyright
Copyright © European Psychiatric Association 2017
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