Global functioning in bipolar patients with cognitive deficits

Abstract

Introduction Bipolar patients show broad cognitive deficits and low global functioning. Objective Assessment of global functioning in bipolars with severe course of illness and cognitive deficits. Aim Improving life quality of bipolar patients with cognitive deficits. Methods One hundred and thirty-seven bipolar (depressive: Hamilton Depression Rating Scale score≥17, manic/hypomanic: Young Mania Rating Scale score≥12, mixed: HAMD score>8 and YMRS score>6, euthymic: 6-month of remission, HAMD score≤8, YMRS score≤6) patients (DSMIVTR). Cognitive battery included standardized test of IQ, attention, executive functioning, memory (working and verbal). GAF (Global Assessment Functioning Scale) scale assessed global functionality. Demographic data, psychiatric history, past/current treatment, length of illness, age of onset were collected. We evaluate global functioning in bipolar patients. Results Cognitive deficits with low functioning are more frequent in bipolars with more severe course of illness (longer illness length, younger onset age, history of frequent manic episodes, higher number of hospitalization). Manic patients showed the most pronounced cognitive deficits. Despite high energy, impaired cognitive function does not support performance and final result is an important decrease of functionality. While for most manic and mixed patients, GAF scores were included between 41 and 50 (any serious deterioration in socio-occupational, school functioning), for majority of depressive patients, GAF scores were included between 51 and 60 (moderate difficulty in socio-occupational, school functioning) and for most euthymic patients, the GAF scores were comprised between 61 and 70 (some difficulty in socio-occupational, school functioning). Manic and mixed patients have similar employment percentages ( Conclusions Severe course of bipolar disorder is associated with cognitive deficits and lower socio-occupational functionality.