ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Mood Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1632857
The impact of neurological and cerebellar soft signs on psychosocial functioning in bipolar disorder
Provisionally accepted
Adrian Andrzej Chrobak1
Zbigniew Soltys2
Anna Starowicz-Filip3
Krzysztof Styczeń1
Malgorzata Dec-Cwiek4,5Dominika Dudek1
Marcin Siwek6*- 1Jagiellonian University Medical College, Department of Adult Psychiatry, Kraków, Poland
- 2Jagiellonian University, Institute of Zoology and Biomedical Research, Laboratory of Experimental Neuropathology, Kraków, Poland
- 3Department of Medical Psychology, Jagiellonian University Medical College, Kraków, Poland
- 4Department of Neurology, Jagiellonian University, Medical College, Kraków, Poland
- 5Department of Neurology, University Hospital, Kraków, Poland
- 6Department of Affective Disorders, Chair of Psychiatry, Jagiellonian University, Medical College, Krakow, Kraków, Poland
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Bipolar disorder (BD) patients present motor dysfunctions in form of neurological and cerebellar soft signs (NSS and CSS). Little is known about clinical utility of those 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 BD patients.Methods: 100 participants were enrolled to this study: 60 euthymic BD patients 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 International Co-operative Ataxia Rating Scale (ICARS).Results: General 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 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.Conclusions: Our results suggest that even "soft" neurological abnormalities may have an impact on BD patients' psychosocial functioning.
Keywords: Cerebellum, Affective Disorders, Neurology, Movement Disorders, Bipolar Disorder
Received: 21 May 2025; Accepted: 10 Jul 2025.
Copyright: © 2025 Chrobak, Soltys, Starowicz-Filip, Styczeń, Dec-Cwiek, Dudek and Siwek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Marcin Siwek, Department of Affective Disorders, Chair of Psychiatry, Jagiellonian University, Medical College, Krakow, Kraków, Poland
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.