The impact of depressive symptoms in stability phases on bipolar disorder outpatients’ functional aspects could be important to determine if they are impaired and their treatment requirements. Our aim is to describe functional impact and social adjustment in stable BD, regarding present subclinical depressive symptoms.

Crossectional, prospective, 16-week study of a cohort of 761 BD patients included by 94 investigators. Clinical stability was assessed at baseline and week 16, with the Clinical Global Impression scale for BD (CGI-BP-M), depressive symptoms at baseline with the Hamilton Depression Rating Scale (HDRS), the Montgomery-Asberg Scale (MADRS) and with the self-applied Center for Epidemiologic Studies-Depression Scale (CES-D). Functional status was evaluated with Social and Occupational Functioning Assessment Scale (SOFAS) and Social Adaptation Self-evaluation Scale (SASS).

Depressive symptoms were detected: mean scores on the HDRS 3.7 (SD 3.1), MADRS 4.9 (SD 4.5) and CES-D 15.2 (SD 9.9) scales. On EEASL mean was 79.5 (SD 12.7), showing a slight decline in social-labour activity and poor social adjustment; SASS mean was 37.5 (SD 7.9). 3.4% of the sample (95%CI 2.0-4.8) presented mild depression with moderate functional impact. The presence of depressive symptoms is related to social-labour functional impact and social maladjustment. The highest correlation coefficients are seen between EEASL and MADRS (r= -0.54, p<0.0001) and between SASS and CES-D (r=-0.47, p<0.0001).

Depressive symptoms on BD outpatients may result in a decline in social-labour functionality and social maladjustment. Self-applied tests performed during follow-up provide important information about patient's functionality.