The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder

BackgroundPatients with bipolar disorder (BD) present motor dysfunctions in the form of neurological and cerebellar soft signs (NSS and CSS, respectively). Little is known about the clinical utility of these symptoms and their impact on patients’ psychosocial functioning. The aim of our study is to...

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Main Authors: Adrian Andrzej Chrobak, Zbigniew Soltys, Anna Starowicz-Filip, Krzysztof Styczeń, Małgorzata Dec-Ćwiek, Dominika Dudek, Marcin Siwek
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1632857/full
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author Adrian Andrzej Chrobak
Zbigniew Soltys
Anna Starowicz-Filip
Anna Starowicz-Filip
Krzysztof Styczeń
Małgorzata Dec-Ćwiek
Małgorzata Dec-Ćwiek
Dominika Dudek
Marcin Siwek
author_facet Adrian Andrzej Chrobak
Zbigniew Soltys
Anna Starowicz-Filip
Anna Starowicz-Filip
Krzysztof Styczeń
Małgorzata Dec-Ćwiek
Małgorzata Dec-Ćwiek
Dominika Dudek
Marcin Siwek
author_sort Adrian Andrzej Chrobak
collection DOAJ
description BackgroundPatients with bipolar disorder (BD) present motor dysfunctions in the form of neurological and cerebellar soft signs (NSS and CSS, respectively). Little is known about the clinical utility of these symptoms and their impact on patients’ psychosocial functioning. The aim of our study is to assess the relationships between severity of NSS and CSS, as well as various dimensions of the daily functioning of patients with BD.MethodsA total of 100 participants were enrolled to this study: 60 patients with euthymic BD and 40 healthy controls (HC). Psychosocial functioning was evaluated with the use of Functioning Assessment Short Test (FAST) total score and its subscales. NSS were assessed with the use of the Neurological Evaluation Scale (NES). CSS were measured with the International Co-operative Ataxia Rating Scale (ICARS).ResultsGeneral psychosocial functioning was decreased by CSS and NSS severity represented by total NES and ICARS scores, as well as by higher measures of kinetic functions, sensory integration, motor coordination, and speech disorders subscales. Patients’ autonomy rates were decreased by total ICARS, kinetic functions, and speech disorders scores. Occupational functioning was limited by the majority of CSS and NSS measures. Cognitive functioning was associated with motor coordination impairments. Leisure time activities were influenced by total CSS severity and kinetic dysfunctions. We have shown that the severity of both CSS and NSS is a full mediator of the associations between duration of treatment and general psychosocial functioning.ConclusionsOur results suggest that even “soft” neurological abnormalities may have an impact on the psychosocial functioning of patients with BD.
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spelling doaj-art-ad2c350cb7ee4f00a947473e75b473172025-08-20T03:56:09ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402025-07-011610.3389/fpsyt.2025.16328571632857The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorderAdrian Andrzej Chrobak0Zbigniew Soltys1Anna Starowicz-Filip2Anna Starowicz-Filip3Krzysztof Styczeń4Małgorzata Dec-Ćwiek5Małgorzata Dec-Ćwiek6Dominika Dudek7Marcin Siwek8Department of Adult Psychiatry, Jagiellonian University Medical College, Cracow, PolandLaboratory of Experimental Neuropathology, Institute of Zoology and Biomedical Research, Jagiellonian University, Cracow, PolandDepartment of Medical Psychology, Jagiellonian University Medical College, Kraków, PolandDepartment of Neurosurgery, University Hospital in Krakow, Kraków, PolandDepartment of Adult Psychiatry, Jagiellonian University Medical College, Cracow, PolandDepartment of Neurology, Jagiellonian University, Medical College, Krakow, PolandDepartment of Neurology, University Hospital, Kraków, PolandDepartment of Adult Psychiatry, Jagiellonian University Medical College, Cracow, PolandDepartment of Affective Disorders, Jagiellonian University Medical College, Cracow, PolandBackgroundPatients with bipolar disorder (BD) present motor dysfunctions in the form of neurological and cerebellar soft signs (NSS and CSS, respectively). Little is known about the clinical utility of these symptoms and their impact on patients’ psychosocial functioning. The aim of our study is to assess the relationships between severity of NSS and CSS, as well as various dimensions of the daily functioning of patients with BD.MethodsA total of 100 participants were enrolled to this study: 60 patients with euthymic BD and 40 healthy controls (HC). Psychosocial functioning was evaluated with the use of Functioning Assessment Short Test (FAST) total score and its subscales. NSS were assessed with the use of the Neurological Evaluation Scale (NES). CSS were measured with the International Co-operative Ataxia Rating Scale (ICARS).ResultsGeneral psychosocial functioning was decreased by CSS and NSS severity represented by total NES and ICARS scores, as well as by higher measures of kinetic functions, sensory integration, motor coordination, and speech disorders subscales. Patients’ autonomy rates were decreased by total ICARS, kinetic functions, and speech disorders scores. Occupational functioning was limited by the majority of CSS and NSS measures. Cognitive functioning was associated with motor coordination impairments. Leisure time activities were influenced by total CSS severity and kinetic dysfunctions. We have shown that the severity of both CSS and NSS is a full mediator of the associations between duration of treatment and general psychosocial functioning.ConclusionsOur results suggest that even “soft” neurological abnormalities may have an impact on the psychosocial functioning of patients with BD.https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1632857/fullcerebellumaffective disordersneurologymovement disordersbipolar disorder
spellingShingle Adrian Andrzej Chrobak
Zbigniew Soltys
Anna Starowicz-Filip
Anna Starowicz-Filip
Krzysztof Styczeń
Małgorzata Dec-Ćwiek
Małgorzata Dec-Ćwiek
Dominika Dudek
Marcin Siwek
The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
Frontiers in Psychiatry
cerebellum
affective disorders
neurology
movement disorders
bipolar disorder
title The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
title_full The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
title_fullStr The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
title_full_unstemmed The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
title_short The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
title_sort impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
topic cerebellum
affective disorders
neurology
movement disorders
bipolar disorder
url https://www.frontiersin.org/articles/10.3389/fpsyt.2025.1632857/full
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