Early functional impairment in bipolar youth: a nested population-based case-control study

J Affect Disord. 2012 Dec 15;142(1-3):208-12. doi: 10.1016/j.jad.2012.04.028. Epub 2012 Sep 7.


Objectives: The objective of this report is to evaluate functioning in bipolar disorder in a population-based sample of young adults (18 to 24 years old). To this end, people with bipolar disorder were compared with matched participants with only depressive episodes and control subjects without a history of mood episodes.

Methods: Case-control study nested in a population-based sample. Caseness was confirmed with the Structured Clinical Interview for DSM-IV. The Functioning Assessment Short Test was used as a measure of general functioning. A multivariate model was elaborated to account for potential confounders.

Results: The sample consisted of 231 subjects. Both bipolar disorder (coef=0.60, SE=0.14, p<0.001) and major depression (coef=0.44, SE=0.14, p=0.001) were associated with functioning in the multivariate model. Current depressive symptoms appeared to influence functioning in those with major depression (Z=2.05, p=0.04), but not in those with bipolar disorder (Z=0.78, p=0.43).

Limitation: Neuropsychological testing was not performed and we see it as an important limitation of this study.

Conclusion: This population-based study further reinforces the notion that functional impairment is a fundamental characteristic of bipolar illness. It is present from early stages and is not completely explained by mood symptoms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology*
  • Bipolar Disorder / physiopathology*
  • Case-Control Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Depressive Disorder, Major / epidemiology*
  • Depressive Disorder, Major / physiopathology*
  • Diagnostic and Statistical Manual of Mental Disorders
  • Early Diagnosis
  • Female
  • Humans
  • Male
  • Multivariate Analysis
  • Substance-Related Disorders / epidemiology