REAL-LIFE FUNCTIONING DOMAINS IN PATIENTS WITH AFFECTIVE DISORDERS.

Abstract

Background: This study investigates impairments in real-life functioning domains among patients with affective disorders (depression and mania), addressing gaps in understanding the relationship between symptom severity and functional outcomes. The research aims to assess real-life functioning domains in clinical populations exhibiting varying degrees of affective disorder severity.

Subjects and methods: A cross-sectional study was conducted with 23 outpatients (16 with depression, 7 with mania) and 44 healthy controls. Participants were assessed using the Hamilton Depression Rating Scale (HDRS), Young Mania Rating Scale (YMRS), and Specific Levels of Functioning Scale (SLOF). Statistical analyses included Chi-square tests for functional impairments and Pearson's correlations to examine associations between symptom severity and functioning.

Results: Key findings demonstrate significant functional deficits in depressive patients across all measured domains (physical functioning, personal care, interpersonal relationships, social acceptability, activities, and work skills), with particularly pronounced impairments in physical functioning (χ²=12.25, p<0.001) and personal care skills (universally low scores). Manic patients exhibited comparable domain-specific impairments, though with less pronounced severity differentiation. Notably, symptom severity (measured via HDRS/YMRS scales) showed minimal correlation with functional outcomes, with the exception of an inverse relationship between depression severity and social acceptability (r=-0.56, p<0.03). Limitations include modest sample sizes and cross-sectional design, warranting future longitudinal research with larger cohorts.

Conclusions: Affective disorders broadly impair real-life functioning irrespective of symptom severity, except for depression's inverse relationship with social acceptability. This finding suggests that functional impairments in affective disorders may represent independent disease dimensions rather than simple byproducts of symptom intensity, emphasizing the need for targeted psychosocial interventions alongside symptom management.