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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

  • Roux, P.1, 2, 3
  • Brunet-Gouet, E.1, 2, 3
  • Ehrminger, M.2, 3
  • Aouizerate, B.3, 4
  • Aubin, V.3, 5
  • Azorin, J. M.3,
  • Bellivier, F.3, 6, 7
  • Bougerol, T.3, 8, 9, 10
  • Courtet, P.3, 11,
  • Dubertret, C.3, 12
  • Kahn, J. P.3, 13, 14
  • Leboyer, M.3, 15, 16, 17
  • Olié, E.3, 11,
  • Etain, B.3, 6, 7, 18
  • Passerieux, C.1, 2, 3
  • 1 Service Universitaire de Psychiatrie d'Adultes et d'Addictologie, Centre Hospitalier de Versailles, France , (France)
  • 2 Centre de recherche en Épidémiologie et Santé des Populations, France , (France)
  • 3 Fondation Fondamental, France , (France)
  • 4 Centre Expert Trouble Bipolaire, Pôle de Psychiatrie Générale et Universitaire (3/4/7), France , (France)
  • 5 Centre Hospitalier Princesse Grace, France , (France)
  • 6 GHU Saint-Louis – Lariboisière – Fernand Widal, France , (France)
  • 7 Université de Paris, France , (France)
  • 8 University Grenoble Alpes, France , (France)
  • 9 CHU de Grenoble et des Alpes, France , (France)
  • 10 Grenoble Institut des Neurosciences (GIN) Inserm U 836, France , (France)
  • 11 Montpellier University, France , (France)
  • 12 Paris Diderot University, France , (France)
  • 13 Fondation Santé des Etudiants de France (FSEF), France , (France)
  • 14 Université de Lorraine, France , (France)
  • 15 Hôpitaux Universitaires Henri Mondor, France , (France)
  • 16 Université Paris Est, France , (France)
  • 17 Inserm, U955, France , (France)
  • 18 King's College London, UK
Published Article
Epidemiology and Psychiatric Sciences
Cambridge University Press
Publication Date
Jul 20, 2020
DOI: 10.1017/S2045796020000566
PMID: 32684190
PMCID: PMC7372163
PubMed Central


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 instead.

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