Validity and reliability of the Functioning Assessment Short Test (FAST) in bipolar disorder

Adriane R Rosa, Jose Sánchez-Moreno, Anabel Martínez-Aran, Manel Salamero, Carla Torrent, Maria Reinares, Mercè Comes, Francesc Colom, Willemijn Van Riel, Jose Luis Ayuso-Mateos, Flávio Kapczinski, Eduard Vieta, Adriane R Rosa, Jose Sánchez-Moreno, Anabel Martínez-Aran, Manel Salamero, Carla Torrent, Maria Reinares, Mercè Comes, Francesc Colom, Willemijn Van Riel, Jose Luis Ayuso-Mateos, Flávio Kapczinski, Eduard Vieta

Abstract

Background: Numerous studies have documented high rates of functional impairment among bipolar disorder (BD) patients, even during phases of remission. However, the majority of the available instruments used to assess functioning have focused on global measures of functional recovery rather than specific domains of psychosocial functioning. In this context, the Functioning Assessment Short Test (FAST) is a brief instrument designed to assess the main functioning problems experienced by psychiatric patients, particularly bipolar patients. It comprises 24 items that assess impairment or disability in six specific areas of functioning: autonomy, occupational functioning, cognitive functioning, financial issues, interpersonal relationships and leisure time.

Methods: 101 patients with DSM-IV TR bipolar disorder and 61 healthy controls were assessed in the Bipolar Disorder Program, Hospital Clinic of Barcelona. The psychometric properties of FAST (feasibility, internal consistency, concurrent validity, discriminant validity (euthymic vs acute patients), factorial analyses, and test-retest reliability) were analysed.

Results: The internal consistency obtained was very high with a Cronbach's alpha of 0.909. A highly significant negative correlation with GAF was obtained (r = -0.903; p < 0.001) pointing to a reasonable degree of concurrent validity. Test-retest reliability analysis showed a strong correlation between the two measures carried out one week apart (ICC = 0.98; p < 0.001). The total FAST scores were lower in euthymic (18.55 +/- 13.19; F = 35.43; p < 0.001) patients, as compared with manic (40.44 +/- 9.15) and depressive patients (43.21 +/- 13.34).

Conclusion: The FAST showed strong psychometrics properties and was able to detect differences between euthymic and acute BD patients. In addition, it is a short (6 minutes) simple interview-administered instrument, which is easy to apply and requires only a short period of time for its application.

Figures

Figure 1
Figure 1
A Pearson correlation between scores of GAF and scores of FAST. * Negative correlation between total scores of FAST and GAF (r = -0.903; p

Figure 2

FAST scores across different mood…

Figure 2

FAST scores across different mood states in bipolar patients. * Significant difference between…

Figure 2
FAST scores across different mood states in bipolar patients. * Significant difference between euthymic patients (18.55; F = 35.43; p
Similar articles
Cited by
References
    1. Translated by Barclay RM.Edinburgh SLR, editor. Kraepelin.E. Manic-Depressive insanity, 1921. New York, New York, Arno Press; 1976.
    1. Goldberg JF, Harrow M, Grossman LS. Course and outcome in bipolar affective disorder: a longitudinal follow-up study. Am J Psychiatry. 1995;152:379–384. - PubMed
    1. MacQueen GM, Young LT, Robb JC, Marriott M, Cooke RG, Joffe RT. Effect of number of episodes on wellbeing and functioning of patients with bipolar disorder. Acta Psychiatr Scand. 2000;101:374–381. doi: 10.1034/j.1600-0447.2000.101005374.x. - DOI - PubMed
    1. Zarate CA Jr., Tohen M, Land M, Cavanagh S. Functional impairment and cognition in bipolar disorder. Psychiatr Q. 2000;71:309–329. doi: 10.1023/A:1004632206684. - DOI - PubMed
    1. Fagiolini A, Kupfer DJ, Masalehdan A, Scott JA, Houck PR, Frank E. Functional impairment in the remission phase of bipolar disorder. Bipolar Disord. 2005;7:281–285. doi: 10.1111/j.1399-5618.2005.00207.x. - DOI - PubMed
Show all 35 references
[x]
Cite
Copy Download .nbib
Format: AMA APA MLA NLM
Figure 2
Figure 2
FAST scores across different mood states in bipolar patients. * Significant difference between euthymic patients (18.55; F = 35.43; p

References

    1. Translated by Barclay RM.Edinburgh SLR, editor. Kraepelin.E. Manic-Depressive insanity, 1921. New York, New York, Arno Press; 1976.
    1. Goldberg JF, Harrow M, Grossman LS. Course and outcome in bipolar affective disorder: a longitudinal follow-up study. Am J Psychiatry. 1995;152:379–384.
    1. MacQueen GM, Young LT, Robb JC, Marriott M, Cooke RG, Joffe RT. Effect of number of episodes on wellbeing and functioning of patients with bipolar disorder. Acta Psychiatr Scand. 2000;101:374–381. doi: 10.1034/j.1600-0447.2000.101005374.x.
    1. Zarate CA Jr., Tohen M, Land M, Cavanagh S. Functional impairment and cognition in bipolar disorder. Psychiatr Q. 2000;71:309–329. doi: 10.1023/A:1004632206684.
    1. Fagiolini A, Kupfer DJ, Masalehdan A, Scott JA, Houck PR, Frank E. Functional impairment in the remission phase of bipolar disorder. Bipolar Disord. 2005;7:281–285. doi: 10.1111/j.1399-5618.2005.00207.x.
    1. Tohen M, Hennen J, Zarate CM Jr., Baldessarini RJ, Strakowski SM, Stoll AL, Faedda GL, Suppes T, Gebre-Medhin P, Cohen BM. Two-year syndromal and functional recovery in 219 cases of first-episode major affective disorder with psychotic features. Am J Psychiatry. 2000;157:220–228. doi: 10.1176/appi.ajp.157.2.220.
    1. Strakowski SM, Williams JR, Fleck DE, Delbello MP. Eight-month functional outcome from mania following a first psychiatric hospitalization. J Psychiatr Res. 2000;34:193–200. doi: 10.1016/S0022-3956(00)00015-7.
    1. Keck PE Jr., McElroy SL, Strakowski SM, West SA, Sax KW, Hawkins JM, Bourne ML, Haggard P. 12-month outcome of patients with bipolar disorder following hospitalization for a manic or mixed episode. Am J Psychiatry. 1998;155:646–652.
    1. Altshuler L, Mintz J, Leight K. The Life Functioning Questionnaire (LFQ): a brief, gender-neutral scale assessing functional outcome. Psychiatry Res. 2002;112:161–182. doi: 10.1016/S0165-1781(02)00180-4.
    1. Dean BB, Gerner D, Gerner RH. A systematic review evaluating health-related quality of life, work impairment, and healthcare costs and utilization in bipolar disorder. Curr Med Res Opin. 2004;20:139–154. doi: 10.1185/030079903125002801.
    1. First MB, Gibbon M. Spitzer.R. Structured Clinical interview for DSM-IV Axis I Disorders. Biometrics Research Deparment. Washington DC, American Psychiatric Press Inc; 1997.
    1. Altshuler LL, Gitlin MJ, Mintz J, Leight KL, Frye MA. Subsyndromal depression is associated with functional impairment in patients with bipolar disorder. J Clin Psychiatry. 2002;63:807–811.
    1. Martinez-Aran A, Vieta E, Torrent C, Sanchez-Moreno J, Goikolea JM, Salamero M, Malhi GS, Gonzalez-Pinto A, Daban C, Alvarez-Grandi S, Fountoulakis K, Kaprinis G, Tabares-Seisdedos R, Ayuso-Mateos JL. Functional outcome in bipolar disorder: the role of clinical and cognitive factors. Bipolar Disord. 2007;9:103–113. doi: 10.1111/j.1399-5618.2007.00327.x.
    1. Vieta E, Cieza A, Stucki G, Chatterji S, Nieto M, Sanchez-Moreno J, Jaeger J, Grunze H, Ayuso-Mateos JL. Developing core sets for persons with bipolar disorder based on the International Classification of Functioning, Disability and Health. Bipolar Disord. 2007;9:16–24. doi: 10.1111/j.1399-5618.2007.00322.x.
    1. Keller MB, Lavori PW, Friedman B, Nielsen E, Endicott J, McDonald-Scott P, Andreasen NC. The Longitudinal Interval Follow-up Evaluation. A comprehensive method for assessing outcome in prospective longitudinal studies. Arch Gen Psychiatry. 1987;44:540–548.
    1. Gitlin MJ, Swendsen J, Heller TL, Hammen C. Relapse and impairment in bipolar disorder. Am J Psychiatry. 1995;152:1635–1640.
    1. Coryell W, Turvey C, Endicott J, Leon AC, Mueller T, Solomon D, Keller M. Bipolar I affective disorder: predictors of outcome after 15 years. J Affect Disord. 1998;50:109–116. doi: 10.1016/S0165-0327(98)00043-3.
    1. Colom F, Vieta E, Martinez-Aran A, Garcia-Garcia M, Reinares M, Torrent C, Goikolea JM, Banus S, Salamero M. [Spanish version of a scale for the assessment of mania: validity and reliability of the Young Mania Rating Scale] Med Clin (Barc ) 2002;119:366–371.
    1. Bobes J, Bulbena A, Luque A, Dal Re R, Ballesteros J, Ibarra N. [A comparative psychometric study of the Spanish versions with 6, 17, and 21 items of the Hamilton Depression Rating Scale] Med Clin (Barc ) 2003;120:693–700. doi: 10.1157/13047695.
    1. Association AP. Diagnostic and Statistical Manual of Mental Disorders. DSM-IV. 4th ed. Washington,DC, APA; 1994.
    1. Visauta B, Batalle P. Métodos estadísticos aplicados Tomo I: Estadística descriptiva. Barcelona, PPU; 2005.
    1. Goldberg JF, Harrow M. Subjective life satisfaction and objective functional outcome in bipolar and unipolar mood disorders: A longitudinal analysis. J Affect Disord. 2005.
    1. Revicki DA, Matza LS, Flood E, Lloyd A. Bipolar disorder and health-related quality of life : review of burden of disease and clinical trials. Pharmacoeconomics. 2005;23:583–594. doi: 10.2165/00019053-200523060-00005.
    1. Depp CA, Davis CE, Mittal D, Patterson TL, Jeste DV. Health-related quality of life and functioning of middle-aged and elderly adults with bipolar disorder. J Clin Psychiatry. 2006;67:215–221.
    1. Keck PE Jr.. Long-term management strategies to achieve optimal function in patients with bipolar disorder. J Clin Psychiatry. 2006;67 Suppl 9:19–24.
    1. Gazalle FK, Andreazza AC, Hallal PC, Kauer-Sant'anna M, Cereser KM, Soares JC, Santin A, Kapczinski F. Bipolar depression: the importance of being on remission. Rev Bras Psiquiatr. 2006;28:93–96.
    1. Hajek T, Slaney C, Garnham J, Ruzickova M, Passmore M, Alda M. Clinical correlates of current level of functioning in primary care-treated bipolar patients. Bipolar Disord. 2005;7:286–291. doi: 10.1111/j.1399-5618.2005.00182.x.
    1. Organization WH. WHO-DAS II Disability Assessment Schedule: Training Manual: a guide to administration:Classification, Assessment and Terminology Team (CAT), Department for Measurement and Health Information Systems. 2004.
    1. Ware JE Jr., Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–483. doi: 10.1097/00005650-199206000-00002.
    1. Suzuki Y, Sakurai A, Yasuda T, Harai H, Kitamura T, Takahashi K, Furukawa TA. Reliability, validity and standardization of the Japanese version of the Social Adjustment Scale-Self Report. Psychiatry Clin Neurosci. 2003;57:441–446. doi: 10.1046/j.1440-1819.2003.01144.x.
    1. Calabrese JR, Hirschfeld RM, Frye MA, Reed ML. Impact of depressive symptoms compared with manic symptoms in bipolar disorder: results of a U.S. community-based sample. J Clin Psychiatry. 2004;65:1499–1504.
    1. Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am J Psychiatry. 1997;154:99–105.
    1. Sanchez-Moreno J, Barrantes-Vidal N, Vieta E, Martinez-Aran A, Saiz-Ruiz J, Montes JM, Akiskal K, Akiskal HS. Process of adaptation to Spanish of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Scale. Self applied version (TEMPS-A) Actas Esp Psiquiatr. 2005;33:325–330.
    1. Rosa AR, Andreazza AC, Sanchez-Moreno J, Gazalle FK, Santin A, Stein A, Barros HM, Vieta E, Kapczinski F. Validation of the Portuguese version of the Lithium Attitudes Questionnaire (LAQ) in bipolar patients treated with lithium: cross-over study. Clin Pract Epidemol Ment Health. 2006;2:32. doi: 10.1186/1745-0179-2-32.
    1. Rosa AR, Andreazza AC, Gazalle FK, Sanchez-Moreno J, Santin A, Stein A, Barros HM, Vieta E, Kapczinski F. Adaptation and validation of the Portuguese version of the Lithium Knowledge Test (LKT) of bipolar patients treated with lithium: cross-over study. Clin Pract Epidemol Ment Health. 2006;2:34. doi: 10.1186/1745-0179-2-34.

Source: PubMed

Sponsor e collaboratori

Condizioni mediche

Interventi farmacologici

3
Sottoscrivi