Trajectories of functioning in bipolar disorders: A longitudinal study in the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort.

Autor:	Godin O; Fondation FondaMental, Créteil, France.; Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France.; AP-HP, HU Henri Mondor, Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Paris, France., Leboyer M; Fondation FondaMental, Créteil, France.; Université Paris Est Créteil, Inserm U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France.; AP-HP, HU Henri Mondor, Departement Medico-Universitaire de Psychiatrie et d'Addictologie (DMU ADAPT), Federation Hospitalo-Universitaire de Médecine de Precision (FHU IMPACT), Paris, France., Mazroui Y; Laboratoire de Probabilités, Statistiques et Modélisation (LPSM), Sorbonne Université, Paris, France., Aouizerate B; Fondation FondaMental, Créteil, France.; Centre Expert Troubles Bipolaires, Service de Psychiatrie Adulte, Hôpital Charles-Perrens, Bordeaux, France., Azorin JM; Fondation FondaMental, Créteil, France.; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France.; CNRS Aix-Marseille Université, Marseille, France., Raoul B; Fondation FondaMental, Créteil, France.; Pôle de Psychiatrie, Assistance Publique Hôpitaux de Marseille, Marseille, France.; CNRS Aix-Marseille Université, Marseille, France., Bellivier F; Fondation FondaMental, Créteil, France.; Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Saint-Louis-Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France., Polosan M; Fondation FondaMental, Créteil, France.; Université Grenoble Alpes, CHU de Grenoble et des Alpes, Grenoble Institut des Neurosciences (GIN) Inserm U1216, Grenoble, France., Courtet P; Fondation FondaMental, Créteil, France.; Département Urgence et Post-urgence Psychiatrique, CHU Montpellier, INSERM U1061, Université de Montpellier, Montpellier, France., Dubertret C; Fondation FondaMental, Créteil, France.; AP-HP, Groupe Hospitalo-Universitaire Nord, DMU ESPRIT, Service de Psychiatrie et Addictologie, Hopital Louis Mourier, Colombes, Inserm U1266, Faculté de Médecine, Université de Paris, Paris, France., Henry C; Fondation FondaMental, Créteil, France.; Department of Psychiatry, Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, Paris, France., Kahn JP; Fondation FondaMental, Créteil, France.; Université de Lorraine, CHRU de Nancy et Pôle de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy, Nancy, France., Loftus J; Fondation FondaMental, Créteil, France.; Pôle de Psychiatrie, Centre Hospitalier Princesse Grace, Monaco, France., Olié E; Fondation FondaMental, Créteil, France.; Département Urgence et Post-urgence Psychiatrique, CHU Montpellier, INSERM U1061, Université de Montpellier, Montpellier, France., Passerieux C; Fondation FondaMental, Créteil, France.; Service Universitaire de Psychiatrie d'Adultes, Centre Hospitalier de Versailles, Le Chesnay, Université Paris-Saclay, UVSQ, Inserm, CESP, Team 'DevPsy', Villejuif, France., Costagliola D; INSERM, Sorbonne Université, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France., Etain B; Fondation FondaMental, Créteil, France.; Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Saint-Louis-Lariboisière-Fernand Widal, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, Paris, France.
Jazyk:	angličtina
Zdroj:	The Australian and New Zealand journal of psychiatry [Aust N Z J Psychiatry] 2020 Oct; Vol. 54 (10), pp. 985-996. Date of Electronic Publication: 2020 Aug 11.
DOI:	10.1177/0004867420945796
Abstrakt:	Objective: We aimed at identifying distinct trajectories of functioning and at describing their respective clinical characteristics in a cohort of individuals with bipolar disorders. Methods: We included a sample of 2351 individuals with bipolar disorders who have been followed-up to 3 years as part as the FondaMental Advanced Centers of Expertise in Bipolar Disorders cohort. Global functioning was measured using the Functioning Assessment Short Test. We used latent class mixed models to identify distinct longitudinal trajectories of functioning over 3 years. Multivariable logistic regression models were used to identify the baseline factors that were associated with the membership to each trajectory of functioning. Results: Three distinct trajectories of functioning were identified: (1) a majority of individuals (72%) had a stable trajectory of mild functional impairment, (2) 20% of individuals had a stable trajectory of severe functional impairment and (3) 8% of individuals had a trajectory of moderate functional impairment that improved over time. The membership to a trajectory of stable severe versus stable mild functional impairment was associated with unemployment, a higher number of previous hospitalizations, childhood maltreatment, a higher level of residual depressive symptoms, higher sleep disturbances, a higher body mass index and a higher number of psychotropic medications being prescribed at baseline. The model that included these seven factors led to an area under the curve of 0.85. Conclusion: This study enabled to stratify individuals with bipolar disorders according to three distinct trajectories of functioning. The results regarding the potential determinants of the trajectory of severe functional impairment needs to be replicated in independent samples. Nevertheless, these potential determinants may represent possible therapeutic targets to improve the prognosis of those patients at risk of persistent poor functioning.
Databáze:	MEDLINE
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