Clinical and personal predictors of functioning in affective disorders: Exploratory results from baseline and 6-month follow-up of a randomised controlled trial
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Comprehensive knowledge of factors causing and sustaining functional impairment in patients with affective disorders is warranted. The aim is to investigate associations between clinical factors (such as affective symptoms) and personal factors (such as personality traits, coping strategies, and childhood trauma experiences) on functioning and improvement of functioning in patients with affective disorders. This exploratory study includes data from 103 patients with bipolar disorder and unipolar depressive disorder. Clinician-rated functioning was assessed at baseline using the Functioning Assessment Short Test (FAST), and performance-based functioning was assessed at baseline and 6-month follow-up using the Assessment of Motor and Process Skills (AMPS). Data on clinical and personal factors were collected at baseline. Personal factors were measured by the Eysenck Personality Inventory (EPQ), Coping Inventory for Stressful Situations (CISS) and Childhood Trauma Questionnaire (CTQ). Pearson correlations and multiple linear regression models were used to analyse the association of clinical and personal factors with baseline functioning (FAST) and to identify predictors of improvement in functioning (AMPS) from baseline to follow-up. At baseline, greater depressive symptom severity, the personality trait neuroticism, emotional coping, and childhood trauma all correlated with poorer functioning (higher FAST scores). In multiple linear regression models, depression severity, emotional coping and childhood trauma were significant predictors of poorer functioning. More childhood trauma was a predictor of less functional improvement measured by AMPS at 6-month follow-up. In conclusion, maladaptive coping styles and depressive symptoms contribute to functional impairment in patients with affective disorders, while childhood trauma has a negative impact on long-term functional outcomes.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Journal of Psychiatric Research |
| Vol/bind | 175 |
| Sider (fra-til) | 386-392 |
| Antal sider | 7 |
| ISSN | 0022-3956 |
| DOI | |
| Status | Udgivet - 2024 |
Bibliografisk note
Funding Information:
The sample consisted of patients with BD (68.9%) and UD (31.1%). There may be differences between the two diagnoses in how the predictors influence overall functioning. However, given the significant overlap in symptoms and prognosis of these two affective disorders, it is reasonable to include them in the same sample. Further, all patients were recruited from the secondary hospital sector. Therefore, the patients with UD had high illness burden and severity, making this group comparable to the patients with BD. As presented in Table 1, baseline sociodemographic, clinical, and personal factors along with functioning were similar in the included patients with BD and UD (as expected, medications were different between the two patient groups with higher use of lithium and anticonvulsants in patients with BD and higher use of antidepressants in patients with UD). Being diagnosed with BD or BD, respectively, was not significantly associated with functional outcomes in the linear regression models, which supports the decision to include both patients with BD and UD in the trial. It is further not uncommon to pool patients with affective disorders because of the similarities in symptomatology between BD and UD, and the underlying genetic overlap between the two diagnoses (Psychiatric Genomics Consortium 2013; McGuffin et al., 2003). Additionally, it is worth noting that 10\u201315% of patients initially diagnosed with UD will later be diagnosed with BD (Kessing et al., 2017).The study was funded by the Mental Health Services, Capital Region of Denmark (grant number F-61181-03-16), the Occupational Therapists' Research Foundation (grant number N/A), the A.P. M\u00F8ller Foundation for the Advancement of Medical Science (grant number N/A), the TRYG Foundation (grant number N/A), Ivan Nielsen Foundation (grant number N/A), Tvergaard Foundation (grant number N/A), L. F. Foghts Foundation (grant number N/A) and Hartmann Foundation (grant number A39083). The funders had no role in study design, data collection, data analysis, data interpretation, or writing the manuscript.
Publisher Copyright:
© 2024
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