Marcadores biológicos e nível de funcionalidade em pacientes bipolares (original) (raw)

Alterations in specific structures of CNS, in particular, fronto-lymbic system, and a reduction of neurons and glial cells appear to be involved in the pathophysiology of bipolar disorder. Glial cells have an important role in the CNS, for example, the production of neurotrophins, especially, Glial Cell Line-derived Neurotrophic Factor (GDNF). In this study, we showed a marked increased in the serum levels of GDNF in depressive (F= 42.31; p=0.004; one-way ANOVA) and manic bipolar patients (F= 42.31; p=0.001; one-way ANOVA), which suggested that GDNF could be involved in the physiopathology of bipolar disorder. On the other hand, alterations in the neurotrophic factors hinder synaptic plasticity mechanisms, may result in cognitive impairment in bipolar patients. In particular, memory difficulties have been reported here, and these difficulties influence occupational and social functioning in these subjects. High rates of functional impairment showed by bipolar patients and a lack of standardization of the instruments available to assess functioning in the studies motivated us to development the scale. The Functioning Assessment Short test (FAST) is a rapid instrument and easy to apply developed to use in psychiatry, especially, bipolar patients. It assesses six specific domains of functioning, such as autonomy, occupational functioning, cognitive functioning, financial issues and leisure time. The validation of FAST was performed by psychometric tests such as internal consistency (Cronbach's alpha: 0.909), concurrent validity compared to the GAF (r=-0.903; p<0.001), validity as a discriminative measure to detect the difference between euthymic (18.55; F=23.59; p<0.001) and acute patients (manic: 38.50; depressive: 42.38; mixed: 43.21), factorial analysis and test-retest reliability (0.953; p<0.01). The FAST scale showed strong psychometric properties and it is now available for use in both clinical practice and investigation settings.