Ludovic Samalin1, Pierre Michel Llorca2, Bruno Giordana3, Vanessa Milhiet4, Liova Yon4, Wissam El-Hage5, Philippe Courtet6, Evguenia Hacques7, Nabil Bedira8, Anne Filipovics8, Rosine Arnaud8, Anne Dillenschneider8, Frank Bellivier9. 1. CHU Clermont-Ferrand, EA7280, Auvergne University, Clermont-Ferrand, France. Electronic address: lsamalin@chu-clermontferrand.fr. 2. CHU Clermont-Ferrand, EA7280, Auvergne University, Clermont-Ferrand, France; Fondation FondaMental, Créteil, France. 3. CHU Pasteur, Nice, France. 4. CHU Henri Mondor, Creteil, France. 5. CRHU Tours, INSERM U930, François Rabelais University, Tours, France. 6. CHU Montpellier, INSERM U1061, Montpellier University, Montpellier, France; Fondation FondaMental, Créteil, France. 7. Otsuka Pharmaceuticals France SAS, Rueil Malmaison, France. 8. Bristol-Myers Squibb, Rueil Malmaison, France. 9. AP-HP, CHU Saint-Louis Lariboisière, F. Widal, Paris, France; INSERM UMRS 1144, Universités Paris Diderot et Paris Descartes, Paris, France; Fondation FondaMental, Créteil, France.
Abstract
BACKGROUND: Some residual symptoms were found to be associated with impaired functioning in euthymic bipolar patients, but their impact and relevance are unclear in clinical practice. We re-examined the functional influence of a large set of residual symptoms in 525 euthymic bipolar outpatients using self- and clinician-rated questionnaires (OPTHYMUM study). METHODS: This was a multi-centre, cross-sectional, non-interventional study of adult bipolar outpatients. All patients were euthymic at the time of assessment (YMRS score <8 and BDRS ≤8). Patients with low functioning (GAF score <60) were compared with the rest of the sample. Patients filled in specific questionnaires concerning their perceptions of different residual and subsyndromal symptoms. RESULTS: Ninety-seven (97) psychiatrists included 525 patients. Of them, 35 patients had a GAF score <60. These "low functioning patients" were more frequently unemployed, had presented more manic episodes and psychotic symptoms, used more atypical antipsychotics or benzodiazepines and received less adjunctive psychotherapy. Concerning residual symptoms, they had more frequent emotional subsyndromal symptoms, disruption of circadian rhythms and sexual disorders. They perceived some cognitive deficits and suffered more social and family stigma. LIMITATIONS: Our study used an arbitrary GAF cut-off score (60) to separate bipolar patients in two groups (low and satisfactory functioning). CONCLUSIONS: Residual symptoms are associated with functional impairment and may represent specific treatment targets. A personalized approach through specific psychotherapeutic programs may lead to more efficient support by the clinician.
BACKGROUND: Some residual symptoms were found to be associated with impaired functioning in euthymic bipolarpatients, but their impact and relevance are unclear in clinical practice. We re-examined the functional influence of a large set of residual symptoms in 525 euthymic bipolar outpatients using self- and clinician-rated questionnaires (OPTHYMUM study). METHODS: This was a multi-centre, cross-sectional, non-interventional study of adult bipolar outpatients. All patients were euthymic at the time of assessment (YMRS score <8 and BDRS ≤8). Patients with low functioning (GAF score <60) were compared with the rest of the sample. Patients filled in specific questionnaires concerning their perceptions of different residual and subsyndromal symptoms. RESULTS: Ninety-seven (97) psychiatrists included 525 patients. Of them, 35 patients had a GAF score <60. These "low functioning patients" were more frequently unemployed, had presented more manic episodes and psychotic symptoms, used more atypical antipsychotics or benzodiazepines and received less adjunctive psychotherapy. Concerning residual symptoms, they had more frequent emotional subsyndromal symptoms, disruption of circadian rhythms and sexual disorders. They perceived some cognitive deficits and suffered more social and family stigma. LIMITATIONS: Our study used an arbitrary GAF cut-off score (60) to separate bipolarpatients in two groups (low and satisfactory functioning). CONCLUSIONS: Residual symptoms are associated with functional impairment and may represent specific treatment targets. A personalized approach through specific psychotherapeutic programs may lead to more efficient support by the clinician.
Authors: J Volkert; M A Schiele; Julia Kazmaier; Friederike Glaser; K C Zierhut; J Kopf; S Kittel-Schneider; A Reif Journal: Eur Arch Psychiatry Clin Neurosci Date: 2015-11-26 Impact factor: 5.270
Authors: Marie-Camille Patoz; Diego Hidalgo-Mazzei; Bruno Pereira; Olivier Blanc; Ingrid de Chazeron; Andrea Murru; Norma Verdolini; Isabella Pacchiarotti; Eduard Vieta; Pierre-Michel Llorca; Ludovic Samalin Journal: Int J Bipolar Disord Date: 2021-06-03