Article

Subsyndromal Depressive Symptoms After Symptomatic Recovery From Mania Are Associated With Delayed Functional Recovery

Department of Psychiatry and Biobehavioral Sciences, The David Geffen School of Medicine at the University of California, Los Angeles, CA, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 05/2011; 72(5):692-7. DOI: 10.4088/JCP.09m05291gre
Source: PubMed

ABSTRACT This study examined whether the presence of subsyndromal depressive symptoms predicted functional recovery after an acute manic episode.
Subjects with bipolar I disorder (according to the Structured Clinical Interview for DSM-IV) who, at the time of symptomatic recovery from an acute manic or hypomanic episode, had a concomitant functional recovery (n = 52) were compared on demographic variables and mood symptoms to those who had symptomatically recovered but not functionally recovered (n = 33). Demographic and mood variables were examined in the nonfunctionally recovered group to assess predictors of time to functional recovery. The primary functional outcome measure used was the Life Functioning Questionnaire, a 5-minute, gender-neutral self-report scale to measure role function in 4 domains: workplace, duties at home, leisure time with family, and leisure time with friends. Participants in the study were recruited from July 2000 through February 2005.
Depressive symptoms, even at a subsyndromal level, were significantly associated with persisting functional impairment after symptomatic recovery from a manic episode (P < .02). Subsyndromal depressive symptoms also significantly predicted a slower time to functional recovery over the next 9 months (P = .006).
The presence of even mild subsyndromal depressive symptoms may interfere with functional recovery in patients with bipolar disorder after symptomatic recovery from a manic or hypomanic episode.

1 Follower
 · 
116 Views
  • Source
    • "For a comprehensive review, see Sanchez- Moreno et al. (2009). Among all the studied variables, the presence of depressive symptoms has been reported as the strongest predictor of poor outcome (Judd et al., 2005; Gitlin et al., 2011; Bonnin et al., 2010; Martino et al., 2009; Strejilevich et al., 2013; Gonzalez-Pinto et al., 2010). This symptomatology also affects neurocognitive performance, even at low levels of depressive symptoms (Bonnin et al., 2012; Torrent et al., 2012). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Most studies on the factors involved in the functional outcome of patients with bipolar disorder have identified subsyndromal depressive symptoms and cognitive impairment as key players. However, most studies are cross-sectional and very few have analyzed the interaction between cognition and subclinical depression. The present study aimed to identify the role of cognition, and particularly verbal memory, and subthreshold depressive symptoms in the functional outcome of patients with bipolar I and II disorder at one year follow-up. Method A confirmatory analysis was performed using the path analysis. A total of 111 euthymic patients were included to test the role of verbal memory as a mediator in the relationship of subthreshold depressive symptoms and functional outcome at one year follow-up. Measures of verbal memory, subthreshold depressive symptoms and functioning (at baseline, at 6 months and at one year follow-up) were gathered through the use of a neuropsychological assessment and validated clinical scales. Results The hypothesized mediation model displayed a good fit to data (Chi=0.393, df=2, p=0.625; RMSEA<0.001 with CI: 0.001–0.125 and CFI=1.00). Functional outcome at one year follow-up was predicted by the functional outcome at baseline, which in turn, was related to subthreshold depressive symptoms at baseline and to the verbal composite memory scores as a mediator variable. Conclusion The results of this study prospectively confirm previous findings on the disabling role of subthreshold depressive symptoms and verbal memory impairment on psychosocial functioning. However, these results come from a sample with moderate to severe functional impairment; hence, as a limitation, this may hinder the generalization of these results.
    Journal of Affective Disorders 01/2014; 160:50–54. DOI:10.1016/j.jad.2014.02.034 · 3.71 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In the framework of our investigation to explain the nucleosynthesis origin of the correlated Ca-Ti-Cr isotopic anomalies in the Ca-Al-rich ''FUN'' inclusion EK-1-4-1 of the Allende meteorite, the nuclear-physics basis in the neutron-rich N=28 region has been updated by including recent experimental data on beta-decay properties and microscopic predictions of neutron-capture cross sections. Charged-particle and subsequent r-process calculations within an entropy-based approach were performed using a complete reaction network. It is shown that there exist two astrophysical scenarios within which the observed isotopic anomalies can be reproduced simultaneously; one at low entropies (about 10) which confirms the earlier suggestrd Sn Ia mechanism, and another at high entropies (about 150) which could be compatible with the neutrino-wind scenario of a SN II.
    01/2001;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A better understanding of the neurobiology of mood disorders, informed by preclinical research and bi-directionally translated to clinical research, is critical for the future development of new and effective treatments. Recently, diverse new targets/compounds have been specifically tested in preclinical models and in proof-of-concept studies, with potential relevance as treatments for mood disorders. Most of the evidence comes from case reports, case series, or controlled proof-of-concept studies, some with small sample sizes. These include (1) the opioid neuropeptide system, (2) the purinergic system, (3) the glutamatergic system, (4) the tachykinin neuropeptide system, (5) the cholinergic system (muscarinic system), and (6) intracellular signaling pathways. These targets may be of substantial interest in defining future directions in drug development, as well as in developing the next generation of therapeutic agents for the treatment of mood disorders. Overall, further study of these and similar drugs may lead to a better understanding of relevant and clinically useful drug targets in the treatment of these devastating illnesses.
    Depression and Anxiety 04/2011; 28(4):267-81. DOI:10.1002/da.20800 · 4.29 Impact Factor
Show more