10003211 J Clin Psychiatry / Document Archive

Psychiatrist.com Home    Keyword Search

Close [X]

Search Our Sites

Enter search terms below (keywords, titles, authors, or subjects). Then select a category to search and press the Search button. All words are assumed to be required. To search for an exact phrase, put it in quotes. To exclude a term, precede it with a minus sign (-).

Keyword search:

Choose a category:

Choosing the appropriate category will greatly improve your chances of finding the best match.

All files at our sites: J Clin Psychiatry, Primary Care Companion, CME Institute, and MedFair

Search materials from our journals:

Abstracts from The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements

PDFs of the full text of The Journal of Clinical Psychiatry, 1996–present, both regular issues and supplements (Net Society Platinum [paid subscribers])

PDFs of the full text of The Primary Care Companion to The Journal of Clinical Psychiatry, 1999–present

Search CME offerings:

CME Institute, including CME from journals , supplements, and Web activities for instant CME credit (Net Society Gold [registered users]); also includes information about our CME program

CME activities from regular issues of The Journal of Clinical Psychiatry (Net Society Gold [registered users])

CME Supplements from The Journal of Clinical Psychiatry (Net Society Gold [registered users])

 

The article you requested is

Mood Symptoms, Functional Impairment, and Disability in People With Bipolar Disorder: Specific Effects of Mania and Depression.[CME]

J Clin Psychiatry 2007;68:1237-1245
Copyright 2007 Physicians Postgraduate Press, Inc.

To view this item, select one of the options below.

  1. NONSUBSCRIBERS
    1. Purchase this PDF for $30
      If you are not a paid subscriber, you may purchase the PDF.
      (You'll need the free Adobe Acrobat Reader.)
    2. Subscribe
      Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($129) or print + online ($166 individual).
  2. PAID SUBSCRIBERS
    1. Activate
      If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
    2. Sign in
      As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
  1. Did you forget your password?

Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send an email

| 54.204.68.109

Objective: To examine the relationship between changes in mood symptoms and changes in functioning or disability in people treated for bipolar disorder.

Method: This study was a secondary analysis of data from 441 patients enrolled in a randomized trial of a care management and psychoeducational intervention for bipolar disorder (diagnosed according to DSM-IV). Study participants were enrolled between August 1999 and October 2000, and follow-up data were collected until October 2001. Five in-person assessments spaced 3 months apart included structured assessment of current mood symptoms (using the Structured Clinical Interview for DSM-IV), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) functional status questionnaire, and questions regarding days of disability during the past 3 months. Repeated-measures analyses examined the associations between each outcome measure and severity of mood symptoms. Additional analyses separated variability in mood symptoms into between-person variation (average symptom severity, or trait effects) and within-person variation (change from average symptom severity, or state effects).

Results: Severity of depression symptoms showed a strong and consistent association with all 4 measures of impairment and disability (SF-36 Role-Emotional score, SF-36 Social Function score, days unable to perform household responsibilities, days disabled from other activities; p < .001 for all comparisons). These associations all remained highly significant (p < .001) after adjustment for co-occurring symptoms of mania. Severity of mania/hypomania symptoms also showed significant association with all disability measures (p < .001 for all comparisons), but these associations were weaker after adjustment for co-occurring symptoms of depression (p < .001 for SF-36 Role-Emotional score, p = .004 for SF-36 Social Function score, p = .069 for days unable to perform household activities, p = .049 for days disabled from other activities). In analyses focused on within-person variation, change in depression was again strongly related to all measures of impairment and disability (p < .001 for all comparisons). After adjustment for co-occurring depression, change in mania/hypomania was not consistently associated with measures of impairment or disability (p = .02 for SF-36 Role-Emotional score; p > .40 for all other comparisons).

Conclusions: Among people treated for bipolar disorder, modest changes in severity of depression are associated with statistically and clinically significant changes in functional impairment and disability. In contrast, changes in severity of mania or hypomania are not consistently associated with differences in functioning. Conventional measures of functioning, however, may not be sensitive to the effects of mania symptoms.