This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. 'This project proposes to study biological and clinical correlates of functional recovery in bipolar subjects after an admission for mania. Specifically, we will explore whether neurocognitive, neuroanatomical or subsyndromal depression variables predict time to functional recovery or persistent functional impairment. We will 1) use a cross-sectional design to test specific hypotheses about factors that may discriminate between bipolar individuals who have concurrent functional recovery with symptomatic recovery versus those whose functional impairment persists after symptomatic recovery; 2) use a prospective design with multiple assessments over time in those patients who are functionally impaired at the time of symptomatic recovery to carefully track the temporal relationship (lag) between symptomatic recovery and functional recovery and test specific hypotheses about predictors of eventual functional recovery, and 3) contrast extreme outcome groups (i.e. those who have rapid functional recovery and those with markedly persistent residual impairment) to explore a hypothesis about brain structure and function in the two groups. An important feature of this study is that it will be done in the context of continuous, competent pharmacotherapy follow-up, thus reducing the potential for functional outcome to be confounded by suboptimal treatment and/or non-compliance. Identifying predictors of functional disability would be a first step toward understanding how and why functional impairment occurs; and would allow for appropriate rehabilitation/intervention strategies to be developed.
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