Ability to perform Activities of Daily Living among patients with bipolar disorder in remission

Aims: Patients with bipolar disorder often experience disability in terms of cognitive impairments and activity limitations even in remission. However, knowledge is sparse concerning the ability to perform Activities of Daily Living (ADL) during remission. The aim of this study was to (1) investigate the observed and self-reported ability to perform ADL tasks and (2) examine the association between observed and self-reported ability to perform ADL in patients with bipolar disorder in remission. Methods: The observed ADL ability was assessed with the Assessment of Motor and Process Skills, a standardized assessment providing interpretation of ADL ability in Lone Decker1, Conny Träger2, Kamilla Miskowiak3, Eva Ejlersen Wæhrens4, Maj Vinberg5 Affiliations: 1MEd. Associate Professor, Department of Physiotherapy and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark; 2MD, Registrar, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; 3PhD, Senior Research Psychologist, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark; 4PhD, Senior researcher, The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Frederiksberg, Denmark, Associate Professor, The Research Initiative for Activity Studies and Occupational Therapy, Institute of Public Health, University of Southern Denmark, Odense, Denmark; 5DMSc, Consultant, Associate Professor, Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark. Corresponding Author: Lone Decker, Sigurdsgade 26, 2200 Copenhagen N, Denmark; Email: [email protected] Received: 03 July 2017 Accepted: 24 August 2017 Published: 19 September 2017 relation to competence, independence, and normative age expectations. Self-reported ADL ability was assessed with the standardized ADLQuestionnaire. Results: Forty-three patients with bipolar disorder in remission (median age 35 years, range 19–58 years) were assessed and overall, they displayed decreased observed ADL motor and ADL process ability relative to normative age. They exhibited increased physical effort, clumsiness or fatigue and/or inefficiency, there was concern for safe task performance and one-third may need assistance to live in the community. While participants reported decreased ADL ability, especially within instrumental ADL, they had a tendency towards evaluating themselves as more competent than what was observed. No relationships between measures of observed and self-reported ADL ability were found. Conclusion: Overall, patients with bipolar disorder in remission showed decreased ability to perform ADL. Clinical practice and future studies are recommended to use both observation-based and self-reported assessments of the ability to perform ADL tasks to fully capture disability in bipolar disorder.