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

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 assessfunctioning have focused on global measures of functional recovery rather than specific domains of psychosocialfunctioning. In this context, the Functioning Assessment Short Test (FAST) is a brief instrument designed to assessthe main functioning problems experienced by psychiatric patients, particularly bipolar patients. It comprises 24items 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 BipolarDisorder Program, Hospital Clinic of Barcelona. The psychometric properties of FAST (feasibility, internalconsistency, 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 significantnegative correlation with GAF was obtained (r = -0.903; p < 0.001) pointing to a reasonable degree of concurrentvalidity. Test-retest reliability analysis showed a strong correlation between the two measures carried out oneweek 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 betweeneuthymic 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.