PMID- 27837572
OWN - NLM
STAT- MEDLINE
DCOM- 20170403
LR  - 20190827
IS  - 1105-2333 (Print)
IS  - 1105-2333 (Linking)
VI  - 27
IP  - 3
DP  - 2016 Jul-Sep
TI  - Clinical and cognitive factors affecting psychosocial functioning in remitted 
      patients with bipolar disorder.
PG  - 182-191
AB  - Impaired interpersonal, social, and occupational functioning is very often 
      observed in patients with bipolar disorder, not only at the acute stages of the 
      illness but in remission as well. This finding raises the question of multiple 
      factors that might affect psychosocial functioning in bipolar patients, such as 
      residual subsyndromal symptoms and neuropsychological deficits. Social cognition 
      impairment, especially impaired Theory of Mind (ToM), might also play an 
      important role in bipolar patients' every-day functioning, similarly to what was 
      found in patients with schizophrenia. The present study aimed to investigate the 
      potential effect of clinical and cognitive factors on the psychosocial 
      functioning of patients with bipolar disorder during remission, assessing ToM 
      along with a broad range of basic cognitive functions. Forty-nine patients with 
      bipolar disorder type I in remission and 53 healthy participants were assessed in 
      general intelligence, working memory, attention, speed processing, verbal 
      learning and memory, and executive functions using a comprehensive battery of 
      neuropsychological tests. The Faux Pas Recognition Test was used to assess ToM. 
      The two groups were matched for gender, age and education level. The Hamilton 
      Rating Scale for Depression (HDRS), the Young Mania Rating Scale (YMRS), and the 
      Brief Psychiatric Rating Scale (BPRS) were also administered to the patients. 
      Every-day functioning was assessed with the Global Assessment of Functioning 
      (GAF). In order to examine the contribution of many factors in psychosocial 
      functioning, we used hierarchical multiple regression analysis. Bipolar patients 
      presented significant impairment compared to healthy participants in all the 
      basic cognitive functions tested with the exception of verbal memory. Moreover, 
      patients had significant poorer performance than healthy controls in overall 
      psyand cognitive ToM but not in affective ToM as measured by Faux Pas. 
      Psychosocial functioning in patient group was significantly correlated to symptom 
      severity-especially depressive (p<0.001) and psychotic symptoms (p=0.001), 
      history of psychotic episodes (p=0.031) and ToM, overall (p=0.001) as well as its 
      cognitive (p=0.023) and affective (p=0.004) components. Only the contribution of 
      ToM in psychosocial functioning remained significant in the final multiple 
      regression model. The findings of the current study indicate that residual 
      symptoms and cognitive dysfunctions, especially deficits in social cognition, 
      negatively affect psychosocial functioning of remitted patients with bipolar 
      disorder. Moreover, our results suggest that ToM may play a central role in these 
      patients' functioning. ToM is a mediator of the relationship between other 
      clinical or cognitive variables and functioning, while it has also significant 
      effect on social skills independently of other factors. Therefore, specific 
      therapeutic interventions targeting social cognitive dysfunction might improve 
      functional outcome in bipolar disorder. Putative contribution of other clinical 
      characteristics (comorbid personality disorders, substance abuse, anxiety) and 
      psychosocial factors (stigma, self-stigma, lack of social network) in bipolar 
      patients' functioning should be examined in future studies.
FAU - Konstantakopoulos, G
AU  - Konstantakopoulos G
AD  - First Department of Psychiatry, Athens University Medical School, Eginition 
      Hospital, Athens, Greece.
AD  - Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute 
      of Psychiatry, King's College London, UK.
FAU - Ioannidi, N
AU  - Ioannidi N
AD  - First Department of Psychiatry, Athens University Medical School, Eginition 
      Hospital, Athens, Greece.
FAU - Typaldou, M
AU  - Typaldou M
AD  - First Department of Psychiatry, Athens University Medical School, Eginition 
      Hospital, Athens, Greece.
FAU - Sakkas, D
AU  - Sakkas D
AD  - Department of Psychiatry, General Hospital "G. Gennimatas" Athens, Greece.
FAU - Oulis, P
AU  - Oulis P
AD  - First Department of Psychiatry, Athens University Medical School, Eginition 
      Hospital, Athens, Greece.
LA  - eng
PT  - Journal Article
PL  - Greece
TA  - Psychiatriki
JT  - Psychiatrike = Psychiatriki
JID - 101534363
SB  - IM
MH  - Bipolar Disorder/*diagnosis/psychology/*rehabilitation
MH  - Brief Psychiatric Rating Scale/statistics & numerical data
MH  - Cognition Disorders/*diagnosis/psychology/*rehabilitation
MH  - Humans
MH  - Neuropsychological Tests/statistics & numerical data
MH  - Psychometrics
MH  - Reference Values
MH  - Rehabilitation, Vocational/psychology
MH  - Schizophrenia/diagnosis/rehabilitation
MH  - Schizophrenic Psychology
MH  - *Social Adjustment
MH  - Social Skills
MH  - Theory of Mind
EDAT- 2016/11/12 06:00
MHDA- 2017/04/04 06:00
CRDT- 2016/11/13 06:00
PHST- 2016/11/13 06:00 [entrez]
PHST- 2016/11/12 06:00 [pubmed]
PHST- 2017/04/04 06:00 [medline]
AID - 10.22365/jpsych.2016.273.182 [doi]
PST - ppublish
SO  - Psychiatriki. 2016 Jul-Sep;27(3):182-191. doi: 10.22365/jpsych.2016.273.182.