- Burdick, Katherine;
- Millett, Caitlin;
- Yocum, Anastasia;
- Altimus, Cara;
- Andreassen, Ole;
- Aubin, Valerie;
- Belzeaux, Raoul;
- Berk, Michael;
- Biernacka, Joanna;
- Blumberg, Hilary;
- Cleare, Anthony;
- Diaz-Byrd, Claudia;
- Dubertret, Caroline;
- Etain, Bruno;
- Lagerberg, Trine;
- Leboyer, Marion;
- Martinez-Aran, Anabel;
- McElroy, Susan;
- Mitchell, Philip;
- Olie, Emilie;
- Olorunfemi, Phebe;
- Passerieux, Christine;
- Peters, Amy;
- Pham, Daniel;
- Polosan, Mircea;
- Potter, Julia;
- Sajatovic, Martha;
- Samalin, Ludovic;
- Schwan, Raymund;
- Shanahan, Megan;
- Solé, Brisa;
- Strawbridge, Rebecca;
- Stuart, Amanda;
- Torres, Ivan;
- Ueland, Torrill;
- Vieta, Eduard;
- Vieta, Eduard;
- Williams, Lana;
- Wrobel, Anna;
- Yatham, Lakshmi;
- Young, Allan;
- Nierenberg, Andrew;
- McInnis, Melvin;
- Forester, Brent;
- Fullerton, Janice;
- Frye, Mark;
- Gard, Sébastien;
- Godin, Ophelia;
- Haffen, Emmanuel;
- Eyler, Lisa;
- Klaus, Federica
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.