Article

Clinical correlates of current level of functioning in primary care-treated bipolar patients.

Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
Bipolar Disorders (impact factor: 5.29). 07/2005; 7(3):286-91. DOI:10.1111/j.1399-5618.2005.00182.x pp.286-91
Source: PubMed

ABSTRACT In this study we examined general assessment of functioning (GAF), and its relation to clinical and demographic factors in bipolar patients. A number of studies, mostly from specialized programs, show that bipolar disorder often leads to occupational and social impairment. Here we report data from patients in a primary care setting.
A total of 252 patients from the Maritime Bipolar Registry with DSM-IV diagnoses of bipolar I or bipolar II disorder participated in the study. GAF ratings during maintenance treatment were compared across clinical and demographic variables.
The mean GAF score in this sample was 67 +/- 17 (range 10-100). The GAF scores followed bimodal distribution with mean values of 50.5 +/- 10.3 and 79.0 +/- 10.3. Decreased functioning was found in patients with chronic illness course, history of rapid cycling, suicidal behaviour, psychiatric comorbidity, hypothyroidism, and diabetes mellitus, regardless of treatment of these conditions. There were no differences in the level of functioning between men and women, bipolar I and II patients, those with and without psychotic episodes, hypertension, treatment with antidepressants or antipsychotics.
Functioning in primary care-treated bipolar patients in maintenance phase of treatment is decreased not only due to specific disorder-related variables, but also due to frequent comorbidity with other psychiatric and medical conditions.

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Keywords

bipolar disorder
 
bipolar II disorder
 
bipolar patients
 
chronic illness course
 
diabetes mellitus
 
DSM-IV diagnoses
 
frequent comorbidity
 
GAF ratings
 
GAF scores
 
general assessment
 
II patients
 
maintenance phase
 
maintenance treatment
 
Maritime Bipolar Registry
 
mean GAF score
 
primary care
 
primary care-treated bipolar patients
 
psychiatric comorbidity
 
specific disorder-related variables
 
suicidal behaviour