Open Access Open Badges Research article

The psychosocial difficulties in brain disorders that explain short term changes in health outcomes

Alarcos Cieza123*, Cristina Bostan3, Jose Luis Ayuso-Mateos4, Cornelia Oberhauser2, Jerome Bickenbach3, Alberto Raggi5, Matilde Leonardi5, Eduard Vieta6 and Somnath Chatterji7

Author Affiliations

1 Faculty of Social and Human Sciences, School of Psychology (Building 44), University of Southampton, Highfield Campus, Southampton, SO17 1BJ, UK

2 Department of Medical Informatics, Biometry and Epidemiology – IBE, Chair for Public Health and Health Services Research, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University (LMU), Munich, Germany

3 Swiss Paraplegic Research, Nottwil, Switzerland

4 Department of Psychiatry, Hospital Universitario de la Princesa, Universidad Autonoma de Madrid, CIBERSAM, Madrid, Spain

5 Neurological Institute C. Besta IRRCS Foundation – Neurology, Public Health and Disability Unit, Milan, Italy

6 Bipolar Disorders Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain

7 Multi-Country Studies, Department of Measurement and Health Information Systems, World Health Organization, Geneva, Switzerland

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BMC Psychiatry 2013, 13:78  doi:10.1186/1471-244X-13-78

Published: 11 March 2013



This study identifies a set of psychosocial difficulties that are associated with short term changes in health outcomes across a heterogeneous set of brain disorders, neurological and psychiatric.


Longitudinal observational study over approximately 12 weeks with three time points of assessment and 741 patients with bipolar disorders, depression, migraine, multiple sclerosis, parkinson’s disease, stroke and traumatic brain injury. The data on disability was collected with the checklist of the International Classification of Functioning, Disability and Health. The selected health outcomes were the Short Form 36 and the World Health Organization Disability Assessment Schedule. Multilevel models for change were applied controlling for age, gender and disease severity.


The psychosocial difficulties that explain the variability and change over time of the selected health outcomes were energy and drive, sleep, and emotional functions, and a broad range of activities and participation domains, such as solving problems, conversation, areas of mobility and self-care, relationships, community life and recreation and leisure.


Our findings are of interest to researchers and clinicians for interventions and health systems planning as they show that in addition to difficulties that are diagnostic criteria of these disorders, there are other difficulties that explain small changes in health outcomes over short periods of time.

Psychosocial; Psychiatric disorders; Neurological disorders; Disability