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Objectives: The aim of this study was to assess the prevalence and the impact of subclinical depressive symptoms (SDS) on the functional outcome of bipolar II (BD) outpatients in remission. Methods: Cross-sectional and prospective 16-week study of a cohort of 739 euthymic BD patients included by 94 investigators in Spain. Clinical stability was assessed at baseline and week 16 with the Clinical Global Impression scale for BD (CGI-BP-M), depressive symptoms at baseline with the Hamilton Depression Rating Scale (HDRS), the Montgomery-Asberg Scale (MADRS) and the self-applied Center for Epidemiologic Studies-Depression Scale (CES-D). Functional status was evaluated with the Social and Occupational Functioning Assessment Scale (SOFAS) and Social Adaptation Self-evaluation Scale (SASS). Results: The sample of type II BD was composed by 202 patients. SDS were detected in 21.3% of patients (95% IC =15.9 to 27.6) at baseline. In apparently symptom-free patients, the incidence of SDS after 16 weeks was 29% (MADRS >7). At baseline, SDS patients compared to non-SDS presented poorer social-occupational performance (SOFAS mean difference -13.3, 95% CI from -17.1 to -9.5) and poorer social adjustment (SASS mean difference -4.3, 95% CI from -7.0 to -1.7). Depressive symptoms were inversely related to functional status and social adjustment: MADRS-SOFAS correlation coefficients r = -0.55 (p7). En la línea base, los pacientes SDS, en comparación con los no SDS, demostraban un desempeño social-ocupacional más pobre (diferencia media SOFAS -13,3, 95% IC de -17,1 a -9,5) y un ajuste social más pobre (diferencia media SASS -4,3, 95% IC de -7,0 a -1,7). Los síntomas depresivos estaban relacionados inversamente con el estado funcional y el ajuste social: coeficientes de correlación MADRS-SOFAS r = -0,55 (p |
