The Impact Of Residual Symptoms On Psychosocial Function Of Patients With Euthymic Bipolar Disorder

Objective:Bipolar disorder(BD)is a major mental disorder characterized by repeated episodes of depression and(hypo)mania,which significantly impact individual’s psychosocial function.Patients with bipolar disorder have interictal period,which is considered as the clinical remission period.During the remission period,a certain number of patients continue to suffer from persistent residual symptoms,such as residual emotional symptoms,sleep symptoms,cognitive symptoms and so on.In addition,patients with bipolar disorder still suffer from severe dysfunction in euthymic,which seriously impact the progress and prognosis of the disease.The purpose of this study is to explore the impact of residual symptoms on psychosocial function of patients with euthymic bipolar disorder.Methods:A total of 81 patients with euthymic bipolar disorder,diagnosed by ICD-10 were enrolled in this study.The demographic survey was conducted.The residual mood symptoms were measured by Hamilton Depression Scale(HAMD),Hypomania Check List(HCL-32)and Hamilton Anxiety Scale(HAMA);Pittsburgh sleep quality index(PSQI)was used to evaluate the residual sleep symptoms;Hopkins Verbal Learning Test revised(HVLT-R),Brief Visuospatial Memory Test revised(BVMT-R),Trail Making Test A(TMT-A)and Digit span task(DST)were used to assess the residual cognitive symptoms;The Global Assessment Function(GAF)was used to evaluate the psychosocial function.All the data were analyzed by SPSS 22.0.Results:(1)There were significant differences in HAMD score(residual depressive symptoms)(F=4.783,P=0.004),HCL-32 score(residual manic symptoms)(F=2.821,P=0.044),digit span test(residual cognitive symptoms,including transient memory and short-term attention)(F=2.835,P=0.044),mood stabilizers(χ~2=11.889,P=0.008),antidepressant(χ~2=22.827,P<0.001)benzodiazepines(χ~2=68.963,P<0.001),gender(χ~2=4.457,P=0.035),education level(H=9.069,P=0.028),marital status(χ~2=48.827,P<0.001),occupation(χ~2=48.086,P<0.001),smoke(χ~2=48.222,P<0.001),drink(χ~2=96.432,P<0.001)and past-history(χ~2=20.753,P<0.001)among different functional states of patients with euthymic bipolar disorder;(2)The overall function of patients with euthymic bipolar disorder was correlated with education level,residual depressive symptoms and residual attention There is a correlation between manic symptoms,cognitive symptoms,the use of antipsychotics(P<0.05);(3)According to the multivariate regression analysis,in patients with euthymic bipolar disorder,the residual depressive symptoms(χ~2=7.861,OR=1.245,95%CI=1.068～1.451,P=0.005)and manic symptoms(χ~2=9.83,OR=1.196,95%CI=1.070～1.337,P=0.002)were the risk factors of psychosocial function impairment;The use of antipsychotics was the risk factor of the functional impairment of patient with euthymic bipolar disorder(χ~2=8.712,OR=1.182,95%CI=1.057～1.321,P=0.003).The use of benzodiazepines was the risk factor of the functional impairment of patient with euthymic bipolar disorder(χ~2=11.836,OR=14.085,95%CI=3.115～62.5,P=0.001).Engaging in agriculture was the risk factor of the functional impairment of patient with euthymic bipolar disorder(χ~2=7.466,OR=250,95%CI=4.673～10000,P=0.006).past smoking(χ~2=8.035,OR=200,95%CI=5.025～7142,P=0.005)were risk factors of psychosocial function impairment of patients with euthymic bipolar disorder.Past drinking(χ~2=4.721,OR=0.034,95%CI=0.002～0.717,P=0.03)and current occasional drinking(χ~2=4.173,OR=0.059,95%CI=0.004～0.891,P=0.041)were protective factor for maintaining a good psychosocial function in euthymic bipolar patients.High level of education was a protective factor for maintaining a good psychosocial function in euthymic bipolar patients(χ~2=8.816,OR=0.666,95%CI=0.509～0.871,P=0.003).Conclusions:1.The risk factors of psychosocial function impairment in patients with euthymic bipolar disorder include:residual depressive symptoms,residual manic symptoms;use of antipsychotics and benzodiazepines;engaging in agriculture;past smoking.2.The protective factors for maintain psychosocial function in patients with euthymic bipolar disorder include:high level of education;past drinking and current occasional drinking.