Minimum clinically important differences for the Functioning Assessment Short Test and a battery of neuropsychological tests in bipolar disorders: results from the FACE-BD cohort

Paul Roux (1, 2, 3) , Eric Brunet-Gouet (1, 2, 3) , Mickael Ehrminger (1, 3) , Bruno Aouizerate (3, 4) , Valérie Aubin (3, 5) , Jean Michel Azorin (3, 6) , Frank Bellivier (3, 7, 8) , Thierry Bougerol (3, 9, 10, 11) , Philippe Courtet (3, 12, 13) , Caroline Dubertret (3, 14) , Jean Pierre Kahn (3, 15, 16) , Marion Leboyer (3, 17, 18, 19) , Émilie Olié (3, 12, 13) , Bruno Etain (3, 7, 8, 20) , Christine Passerieux (1, 2, 3)

1 CESP - Centre de recherche en épidémiologie et santé des populations
2 CHV - Centre Hospitalier de Versailles André Mignot
3 Fondation FondaMental [Créteil]
4 Centre hospitalier Charles Perrens [Bordeaux]
5 CHPG - Centre Hospitalier Princesse Grace de Monaco
6 Hôpitaux Sud - Département Universitaire de Psychiatrie - [Hôpital Sainte Marguerite - APHM]
7 Département de Psychiatrie et de Médecine Addictologique
8 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie
9 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
10 UGA - Université Grenoble Alpes
11 GIN - [GIN] Grenoble Institut des Neurosciences
12 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
13 PSNREC - Neuropsychiatrie : recherche épidémiologique et clinique
14 Hôpital Louis Mourier - AP-HP [Colombes]
15 Fondation Santé des Etudiants de France
16 UL - Université de Lorraine
17 DHU PePsy - Psychiatrie et Neurologie personnalisées [AP-HP Hôpital Henri-Mondor]
18 UPEC Médecine - Université Paris-Est Créteil Val-de-Marne - Faculté de médecine
19 Equipe 15 - Psychiatrie Translationnelle
20 Institute of Psychiatry, Psychology & Neuroscience, King's College London

AIMS: Establishing the minimum clinically important difference (MCID) in functioning and cognition is essential to the interpretation of the research and clinical work conducted in bipolar disorders (BD). The present study aimed to estimate the MCID for the Functioning Assessment Short Test (FAST) and a battery of neuropsychological tests in BD. METHODS: Anchor-based and distributive methods were used to estimate the MCID for the FAST and cognition using data from a large, multicentre, observational cohort of individuals with BD. The FAST and cognition were linked with the Clinical Global Impressions Scale-Severity (CGI-S) and Global Assessment of Functioning (GAF) using an equipercentile method. The magnitude of the standard error measurement (s.e.m.) provided another estimate of the MCID. RESULTS: In total, 570 participants were followed for 2 years. Cross-sectional CGI-S and GAF scores were linked to a threshold ⩽7 on the FAST for functional remission. The MCID for the FAST equalled 8- or 9-points change from baseline using the CGI-S and GAF. One s.e.m. on the FAST corresponded to 7.6-points change from baseline. Cognitive variables insufficiently correlated with anchor variables (all ρ <0.3). One s.e.m. for cognitive variables corresponded to a range of 0.45 to 0.93-s.d. change from baseline. CONCLUSIONS: These findings support the value of the estimated MCID for the FAST and cognition and may be a useful tool to evaluate cognitive and functional remediation effects and improve patient functional outcomes in BD. The CGI-S and GAF were inappropriate anchors for cognition. Further studies may use performance-based measures of functioning instea

Mots clés: Attention; bipolar disorders; cognition; executive functions; memory; minimal clinical important differences; social functioning; speed processing; working memory

Domaines: Sciences du Vivant [q-bio]; Psychiatrie et santé mentale

Paul Roux, Eric Brunet-Gouet, Mickael Ehrminger, Bruno Aouizerate, Valérie Aubin, et al.. Minimum clinically important differences for the Functioning Assessment Short Test and a battery of neuropsychological tests in bipolar disorders: results from the FACE-BD cohort. Epidemiology and Psychiatric Sciences, 2020, 29, ⟨10.1017/S2045796020000566⟩. ⟨hal-02927375⟩