Psychosocial functioning in older adults with bipolar disorder: Spanish validation of the Functioning Assessment Short Test for Older adults (FAST-O).

OBJECTIVES

Valid measures of psychosocial outcomes in older adults with bipolar disorder (OABD) are needed for clinical and research purposes. This study aimed to validate the Spanish version of the Functioning Assessment Short Test for Older Adults (FAST-O), the first instrument specifically developed to assess psychosocial functioning in OABD.

METHODS

We investigated the scale's psychometric properties in terms of internal consistency (reliability), concurrent validity (Spearman correlation), discriminant validity (ROC curve and OABD vs healthy controls -HCs-), and construct validity (internal structure) in a sample of fully or partially remitted patients with OABD (n = 118) and HCs (n = 118) coming from a multi-site observational study. Participants were assessed with the FAST-O and additional clinical and cognitive measures. The Social and Occupational Functioning Assessment Scale (SOFAS) was used to assess concurrent validity. We also examined differences in FAST-O scores between fully euthymic and subsyndromal patients.

RESULTS

The FAST-O had an excellent internal consistency (Cronbach's α = 0.91), was moderately correlated with the SOFAS (σ = -0.49, p < .001), and had a good discriminant capacity value (AUC ROC = 0.86 95 % CI [0.81, 0.91]). Significant differences were observed between OABD and HCs in the FAST-O, with OABD displaying significantly higher psychosocial impairment in global and domain scores. The internal structure was similar to the internal structure of the original FAST-O.

CONCLUSIONS

The Spanish version of the FAST-O showed good psychometric properties, and was valid and reliable for measuring psychosocial outcomes in OABD. The FAST-O should be implemented in clinical and research settings and cognitive treatment trials.