Stanley foundation bipolar network: predictors of psychosocial outcome

Background and Aims: Impairments in psychosocial functioning have been demonstrated in 30–60% of adults with Bipolar Disorder(BD). The aim of this project was to investigate the impact of the following factors on longitudinal psychosocial outcome in participantswith BD: comorbid mental health disorders, age at onset and duration of untreated BD. Methods: Baseline factors (random effects) were entered into aMixed Effects Model with Global Assessment of Functioning(GAF) score as the longitudinal outcome measure. Relative(Akaike’s Information Criterion) and absolute (R²) model fit were calculated. Results: Complete data was available for 469 participants. Presence of any lifetime anxiety disorder (t = -2.27, p = 0.02), but not substance use disorders (t = 0.04, p = 0.97) or attention deficit hyperactivity disorder (t = 0.44, p = 0.66), predicted poorer GAFscores. Longer duration of untreated BD (t = -2.41, p = 0.02) also predicted poorer GAF scores, with younger age at onset (t = 1.84,p = 0.07) showing a trend towards this result. The final model predicted just over half of the variance (R² = 0.545) in the sample. Conclusions: Studies have shown that the resolution of clinicalsymptoms is rarely followed by recovery of psychosocial functioning.The growing evidence base added to by this study suggestscomorbid anxiety disorders are a significant factor hindering psychosocialrecovery. This finding may have implications for screeningtools and staging systems. Both have been incorporatedextensively into many medical fields, and there is promising evidenceof their utility in BD. The current results suggest an importantrole for anxiety disorders in the future development of thesetools, while the mechanisms behind these findings deserve furtherexploration