Functioning and illness progression in bipolar disorder

Abstract Bipolar disorder is a chronic and severe mental disorder, the sixth leading cause of disability-adjusted life years in the world among people aged 15–44. Psychosocial dysfunction in bipolar disorder is not limited to symptomatic periods, but may be enduring or result in sustained disability. Psychosocial functioning is a complex concept that involves a person’s ability to perform the tasks of daily life and to engage in relationships with other people. Bipolar disorder affects several areas of psychosocial functioning and impairment in the occupational domain is pronounced. Although the basis for such limited functional recovery is not entirely clear, it may be associated with progressive course of the illness. Recently, we showed that there is a strong linear association between functional impairment and clinical stages of bipolar disorder. Additionally, neurocognitive deficits have emerged as an important predictor to poor functioning in bipolar disorder.