Journal of affective disorders · 2025
Clinical outcomes of youth at familial risk for bipolar disorder: A 2-year longitudinal, observational study.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Pandina Gahan, DelBello Melissa P, Rassnick Stefanie, Solanki Bhavna, Canuso Carla M, Fristad Mary A, Correll Christoph U, Nurnberger John I, Singh Manpreet K, McInnis Melvin G, Atkinson Sarah, Stedman Mary, Goes Fernando S, Strakowski Stephen M, Greer Tracy L, Nierenberg Andrew A, Salvadore Giacomo, Drevets Wayne C
Аннотация
BACKGROUND: Functional status may predict mood outcomes in youth at familial risk for bipolar disorder (BD). This study examined whether baseline functional status of at-risk youth is linked to clinical outcomes over 2-years.
METHOD: Aretaeus (named for Aretaeus of Cappadocia) is a multicenter, prospective, observational study. Participants (15-25 years), all offspring of a parent with BD, were stratified by Global Assessment of Function (GAF) score into functionally impaired (GAF ≤ 70; Low-GAF) or not-impaired (GAF > 70; High-GAF) groups. The primary outcome was difference in time spent with clinically significant mood symptoms ([hypo]mania, depression) between groups, assessed using Longitudinal Interval Follow-up Evaluation Psychiatric Status Rating (LIFE-PSR). Outcomes were evaluated at baseline and every 3-months for 24-months.
RESULTS: Of 223 eligible participants, 156 (70 %) completed the study. Completion rates were lower in the Low- vs. High-GAF group (60 % vs. 76 %; p = 0.008). Time spent with clinically significant mood symptoms was higher in Low- vs. High-GAF group at baseline (28 vs. 6 weeks, p < 0.0001) and 24-months (30 vs. 11 weeks, p = 0.009). Serious psychiatric adverse events (7.0 % vs. 1.0 %) and psychiatric medication use were more frequent in Low- vs. High-GAF group. BD and new-onset major depressive disorder diagnoses were similar between groups over 24-months.
CONCLUSIONS: Baseline Functional impairment in at-risk youth was linked to more time spent with clinically relevant depressive symptoms. Low-GAF participants experienced mood symptoms for a greater period of time than High-GAF participants, suggesting that early functional impairment relates to poorer-clinical course. Assessing psychosocial function in at-risk individuals may help guide future care.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03017781.
METHOD: Aretaeus (named for Aretaeus of Cappadocia) is a multicenter, prospective, observational study. Participants (15-25 years), all offspring of a parent with BD, were stratified by Global Assessment of Function (GAF) score into functionally impaired (GAF ≤ 70; Low-GAF) or not-impaired (GAF > 70; High-GAF) groups. The primary outcome was difference in time spent with clinically significant mood symptoms ([hypo]mania, depression) between groups, assessed using Longitudinal Interval Follow-up Evaluation Psychiatric Status Rating (LIFE-PSR). Outcomes were evaluated at baseline and every 3-months for 24-months.
RESULTS: Of 223 eligible participants, 156 (70 %) completed the study. Completion rates were lower in the Low- vs. High-GAF group (60 % vs. 76 %; p = 0.008). Time spent with clinically significant mood symptoms was higher in Low- vs. High-GAF group at baseline (28 vs. 6 weeks, p < 0.0001) and 24-months (30 vs. 11 weeks, p = 0.009). Serious psychiatric adverse events (7.0 % vs. 1.0 %) and psychiatric medication use were more frequent in Low- vs. High-GAF group. BD and new-onset major depressive disorder diagnoses were similar between groups over 24-months.
CONCLUSIONS: Baseline Functional impairment in at-risk youth was linked to more time spent with clinically relevant depressive symptoms. Low-GAF participants experienced mood symptoms for a greater period of time than High-GAF participants, suggesting that early functional impairment relates to poorer-clinical course. Assessing psychosocial function in at-risk individuals may help guide future care.
TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03017781.