The impact of sex in the effectiveness of functional remediation in bipolar disorder

IF 5.3 2区医学 Q1 PSYCHIATRY Acta Psychiatrica Scandinavica Pub Date : 2024-09-07 DOI:10.1111/acps.13748

Maria Serra-Navarro, Derek Clougher, Brisa Solé, Jose Sánchez-Moreno, Ana González-Pinto, Esther Jiménez, Benedikt L. Amann, Vicent Balanzá-Martínez, Rafael Tabarés-Seisdedos, Celso Arango, Vivian Accardo, María Paz García-Portilla, Ángela Ibáñez, José Manuel Crespo, José Luis Ayuso-Mateos, Silvia Amoretti, Carla Torrent, Anabel Martínez-Aran, Eduard Vieta, CIBERSAM Functional Remediation Group

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Abstract

Background

Functional recovery remains a core clinical objective for patients with bipolar disorder (BD). Sociodemographic, clinical, and neurocognitive variables are associated with long-term functional impairment, yet the impact of sex differences is unclear. Functional remediation (FR) is a validated intervention aimed at achieving functional recovery in BD. The present study assessed the effect of sex differences of FR on psychosocial functioning at post-treatment (6-months) and 12-month follow-up (FUP). To the best of our knowledge, this is the first study to explore the role of sex as a factor in the efficacy of FR.

Methods

157 participants with BD were randomly assigned to either FR (N = 77) or treatment as usual group (80). Clinical, sociodemographic, neuropsychological, and functional data were obtained using a comprehensive assessment battery. Sex differences were explored via a general linear model (GLM) for repeated measures to compare the effect of sex on the intervention over time (6 months and FUP).

Results

Results demonstrated that FR benefits both sexes, males (p = 0.001; d’ = 0.88) and females (p = 0.04; d’ = 0.57), at 6 months suggesting a generalized functional improvement. Conversely, at 12-month FUP sex differences were observed only in males (p = 0.005; d’ = 0.68).

Conclusions

FR is a beneficial intervention for males and females after treatment, suggesting that there are no relevant distinct needs. Females may benefit from ongoing psychosocial functioning booster sessions after the intervention to maintain original improvements. Future research exploring sex differences could help to identify strategies to offer personalized FR intervention approaches in individuals with BD.

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性别对双相情感障碍功能性矫正效果的影响。

背景：功能恢复仍是双相情感障碍（BD）患者的核心临床目标。社会人口学、临床和神经认知变量与长期功能障碍有关，但性别差异的影响尚不明确。功能性补救（FR）是一种有效的干预措施，旨在实现双相情感障碍患者的功能恢复。本研究评估了性别差异对治疗后（6 个月）和 12 个月随访（FUP）期间心理社会功能的影响。方法：157 名 BD 患者被随机分配到 FR 组（77 人）或常规治疗组（80 人）。使用综合评估电池获取临床、社会人口学、神经心理学和功能数据。通过重复测量的一般线性模型（GLM）探讨了性别差异，以比较性别在不同时间（6 个月和家庭综合评估）对干预的影响：结果表明，在 6 个月时，FR 对男性（p = 0.001；d' = 0.88）和女性（p = 0.04；d' = 0.57）都有益处，表明功能得到了普遍改善。相反，在为期 12 个月的功能障碍评估中，仅在男性中观察到性别差异（p = 0.005；d' = 0.68）：结论：FR 在治疗后对男性和女性都是一种有益的干预措施，这表明并不存在相关的不同需求。女性可能会受益于干预后持续的社会心理功能强化训练，以保持原有的改善。未来探索性别差异的研究将有助于确定为 BD 患者提供个性化 FR 干预方法的策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Psychiatrica Scandinavica 医学-精神病学

CiteScore

11.20

自引率

3.00%

发文量

135

审稿时长

6-12 weeks

期刊介绍： Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers. Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.