Personality Functioning Associated With Global Functioning in Bipolar Disorder I

Personality functioning had a significant predictive effect on global functioning for patients in the euthymic phase of bipolar disorder I, according to findings published in Psychiatry Research.

Researchers collected demographic and clinical features from 100 patients with bipolar disorder I whose disease was in remission. Patients were assessed for global functionality per the Bipolar Disorder Functioning Questionnaire (BDFQ) and the Global Assessment of Functioning (GAF) scale, with higher scores demonstrating better functionality. The Level of Personality Functioning Scale was used to quantify personality functionality in several domains following semistructured interviews with participants. Anxious and depressive symptoms were captured using the Patients Health Questionnaire-Somatic, Anxiety, and Depressive Symptoms.

Scientists constructed linear regression models to assess the predictive power of certain personality domains on global functionality. Higher GAF scores were significantly correlated with better personality functioning in the domains of identity (P <.001), self-direction (P <.001), empathy (P <.001), and intimacy (P <.001). Data also indicated that improved intimacy scores as a dimension of personality had a predictive positive effect on BDFQ total score (P =.01) as well as on certain GAF subscores, including social withdrawal (P =.04), relationships with friends (P =.005), and participation in social activities (P =.01). Correspondingly, decreases in personality functioning predicted impaired global functioning.

Higher PHQ-9 scores were negatively correlated both with BDFQ total score (P =.003) and with several BDFQ subscores, including emotional functioning (P =.005), intellectual functioning (P =.004), sense of stigmatization (P <.001), and social withdrawal (P =.002). Patients with psychiatric comorbidities had significantly lower BDFQ total scores (P <.001) and lower subscale scores for emotional functioning (P =.017), intellectual functioning (P =.039), sense of stigmatization (P =.002), social withdrawal (P =.001), relations with friends (P =.003), and participation in social activities (P =.034) compared with patients without. Similar effects were observed for patients with substance use disorders.

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These results indicate that personality functioning informs global functionality for patients in the euthymic phase of bipolar disorder I and that the effect is enhanced for patients with subsyndromal depressive symptoms or additional psychiatric comorbidities. These results highlight the potential utility of incorporating personality functioning assessments into bipolar disorder I treatment plans to fully restore global functioning during remission.  


Kizilkurt OK, Gulec MY, Giynas FE, Gulec H. Effects of personality functioning on the global functioning of patients with bipolar disorder I [published online March 20, 2018]. Psychiatry Res. doi:10.1016/j.psychres.2018.03.028