Predictors of Functional Impairment in Bipolar Disorder: Results from 13 Cohorts from Seven Countries by The Global Bipolar Cohort Collaborative

TY - JOUR

T1 - Predictors of Functional Impairment in Bipolar Disorder: Results from 13 Cohorts from Seven Countries by The Global Bipolar Cohort Collaborative

AU - Strawbridge, Becci

AU - Cleare, Anthony

AU - Young, Allan

N1 - Funding Information: Funding informationSupported in part by (1) National Alliance for Ment al Illness (NAMI) gift to KEB, AN, and MGM; (2) The Baszucki Brain Research Foundation. Individual investigator funding sources include: KEB is supported by R01MH124381; CEM is supported by the Stuart T. Hauser Research Training Program in Biological and Social Psychiatry Federal Postdoctoral Training Grant NIMH T32 016259–40. OAA received support from the Research Council of Norway (223273), the KG Jebsen Stiftelsen (SKGJ‐MED‐021), EU's H2020 RIA grant # 847776 CoMorMent, South‐East Norway Health Authority (2019–108). HPB is supported by R01MH113230. MB is supported by a NHMRC Senior Principal Research Fellowship (1156072). The FACE‐BD cohort was supported by the Foundation FondaMental, Institut National de la Santé et de la Recherche Médicale (INSERM), AP‐HP, and by the Investissements d'Avenir program managed by the ANR under reference ANR‐11‐IDEX‐0004‐02 and ANR‐10‐COHO‐10‐01. LTE is supported by the International Society for Bipolar Disorder Bowden‐Massey Strategic Research Initiative and the Desert‐Pacific VA Mental Illness Research Education and Clinical Center. MAF, JMB, and SLM are supported by the Marriott Foundation and the Mayo Foundation. JMF acknowledges the Janette Mary O'Neil Research Fellowship. TVL received support from the Research Council of Norway (288542). FK is supported by the Early Postdoc Mobility Fellowship of the Swiss National Science Foundation (SNSF) and a Fellowship by the Novartis Foundation for medical‐biological Research. BPF has recently received funding from NIH, Biogen, Lilly, Eisai, Rogers Family Foundation, Spier Family Foundation. MGM is supported by the HC Prechter Bipolar Research Program, the Richard Tam Foundation, NIMH (MH114835 & UL1TR002240). PBM is supported by an Australian NHMRC Investigator Grant (1177991). AAN was supported, in part, by the Dauten Family Center for Bipolar Treatment Innovation and the Thomas P. Hackett, MD Chair in Psychiatry at Massachusetts General Hospital. AP is supported by NIMH 1K23MH122676. MS has received research grants within the past 3 years: Nuromate, Otsuka, Alkermes, International Society for Bipolar Disorders (ISBD), National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC), Patient‐Centered Outcomes Research Institute (PCORI). EV thanks the support of the Spanish Ministry of Science and Innovation (PI15/00283, PI18/00805) integrated into the Plan Nacional de I + D + I and co‐financed by the ISCIII‐Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (FEDER); the Instituto de Salud Carlos III; the CIBER of Mental Health (CIBERSAM); the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2017 SGR 1365), the CERCA Programme, and the Departament de Salut de la Generalitat de Catalunya for the PERIS grant SLT006/17/00357. LJW is supported by a NHMRC Emerging Leadership Fellowship (1174060). AHY has received funding from NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC‐VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK). Janssen (UK). AS, LW, and MB (Deakin) are supported by a competitive project grant from the National Health and Medical Research Council (NHMRC; ID 1104438). Funding Information: KEB has served as a consultant or advisor to Sunovion and Dainippon Sumitomo Pharma; OAA has received speaker's honorarium from Lundbeck and Sunovion and is a consultant to HealthLytix. MB has received Grant/Research Support from the NIH, Cooperative Research Centre, Simons Autism Foundation, Cancer Council of Victoria, Stanley Medical Research Foundation, Medical Benefits Fund, National Health, and Medical Research Council, Medical Research Futures Fund, Beyond Blue, Rotary Health, A2 milk company, Meat and Livestock Board, Woolworths, Avant and the Harry Windsor Foundation, has been a speaker for Abbot, Astra Zeneca, Janssen and Janssen, Lundbeck and Merck and served as a consultant to Allergan, Astra Zeneca, Bioadvantex, Bionomics, Collaborative Medicinal Development, Janssen and Janssen, Lundbeck Merck, Pfizer, and Servier—all unrelated to this work. AJC has received honoraria for lectures or consulting from Lundbeck, Livanova, Janssen & Allergan, and a research grant from Protexin Probiotics International Ltd. MAF has had grant seed support from Assurex Health, Mayo Foundation, Medibio. Mayo Clinic has a financial interest in AssureRX and OneOme. BPF has served on advisory boards for Biogen and Acadia Pharmaceuticals, as an Advisor to Patina Health, and has served on the Pharmacy and Therapeutics Committee for CVS Health. SLM has been a consultant to or member of the scientific advisory boards of Avanir, F. Hoffmann‐La Roche Ltd., Idorsia, Intra‐Cellular Therapies, Janssen, Mitsubishi Tanabe Pharma America, Myriad, Novo Nordisk, Otsuka, Signant Health (formerly Brackett), Sunovion, and Takeda (formerly Shire), has been a principal or co‐investigator on studies sponsored by Allergan, Brainsway, Janssen, Jazz, Marriott Foundation, Myriad, National Institute of Mental Health, Novo Nordisk, Otsuka, Sunovion, and Takeda (formerly Shire), is also an inventor on United States Patent No. 6,323,236 B2, Use of Sulfamate Derivatives for Treating Impulse Control Disorders, and along with the patent's assignee, University of Cincinnati, Cincinnati, Ohio, has received payments from Johnson & Johnson, which has exclusive rights under the patent. MGM has received consulting fees and research support from Janssen Pharmaceuticals. In the past 12 months, AAN received consulting fees, grants, or honoraria from Alkermes, Belvior Publishing, Ginger Inc., Merck, Myriad, Neuronetics, Patient‐Centered Outcomes Research Institute, Physician's Postgraduate Press, Protagenics, Slack Publishing, Sunovion, UpToDate Wolters Kluwer, and Wiley Publishing. PBM has received honoraria from Sanofi (Hangzhou) and Janssen Australia. MS has served as a consultant for Alkermes, Otsuka, Janssen, Myriad, Health Analytics, Frontline Medical Communications, has received royalties from Springer Press, Johns Hopkins University Press, Oxford Press, UpToDate, and received compensation for the preparation of CME activities: American Physician's Institute, MCM Education, CMEology, Potomac Center for Medical Education, Global Medical Education, Creative Educational Concepts, Psychopharmacology Institute. IJT has served as a consultant for Community Living British Columbia. RS has received honoraria from Lundbeck. EV has received grants and served as consultant, advisor, or CME speaker for the following entities: AB‐Biotics, Abbott, AbbVie, Angelini, Boehringer‐Ingelheim, Dainippon Sumitomo Pharma, Ferrer, Gedeon Richter, GH Research, Janssen, Lundbeck, Novartis, Otsuka, Sage, Sanofi‐Aventis, Sunovion, and Takeda, outside the submitted work. LJW has received Grant/Research support from Eli Lilly, Pfizer, The University of Melbourne, Deakin University, and the NHMRC. LNY has been on the speaker/advisory boards for or has received research grants from Abbvie, Alkermes, Allergan, Canadian Network for Mood and Anxiety Treatments (CANMAT), Canadian Institutes of Health Research (CIHR), DSP, Gideon Richter, Intracellular Therapies, Merck, Sanofi, and Sunovion. AHY has received honoraria for lectures and advisory boards for all major pharmaceutical companies with drugs used in affective and related disorders including: Astrazenaca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS, as well as investigator‐initiated studies from AZ, Eli Lilly, and Lundbeck. CMA, JMB, HPB, CDB, FK, AMA, CEM, PO, DLP, AP, JP, MS, BS, AY have nothing to disclose. Publisher Copyright: © 2022 The Authors. Bipolar Disorders published by John Wiley & Sons Ltd.

PY - 2022/11

Y1 - 2022/11

N2 - Objectives: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD. Methods: Thirteen cohorts from 7 countries included n = 5882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived “higher versus lower function” as the dependent variable and selected clinical and demographic variables as predictors. Results: We found high rates of functional impairment, ranging from 41 to 75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, the presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning. Conclusions: The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients' complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.

AB - Objectives: Persistent functional impairment is common in bipolar disorder (BD) and is influenced by a number of demographic, clinical, and cognitive features. The goal of this project was to estimate and compare the influence of key factors on community function in multiple cohorts of well-characterized samples of individuals with BD. Methods: Thirteen cohorts from 7 countries included n = 5882 individuals with BD across multiple sites. The statistical approach consisted of a systematic uniform application of analyses across sites. Each site performed a logistic regression analysis with empirically derived “higher versus lower function” as the dependent variable and selected clinical and demographic variables as predictors. Results: We found high rates of functional impairment, ranging from 41 to 75%. Lower community functioning was associated with depressive symptoms in 10 of 12 of the cohorts that included this variable in the analysis. Lower levels of education, a greater number of prior mood episodes, the presence of a comorbid substance use disorder, and a greater total number of psychotropic medications were also associated with low functioning. Conclusions: The bipolar clinical research community is poised to work together to characterize the multi-dimensional contributors to impairment and address the barriers that impede patients' complete recovery. We must also identify the core features which enable many to thrive and live successfully with BD. A large-scale, worldwide, prospective longitudinal study focused squarely on BD and its heterogeneous presentations will serve as a platform for discovery and promote major advances toward optimizing outcomes for every individual with this illness.

UR - http://www.scopus.com/inward/record.url?scp=85128040422&partnerID=8YFLogxK

U2 - 10.1111/bdi.13208

DO - 10.1111/bdi.13208

M3 - Article

SN - 1398-5647

VL - 24

SP - 709

EP - 719

JO - Bipolar Disorders

JF - Bipolar Disorders

IS - 7

ER -