[Bipolar disorder and quality of life: A cross-sectional study including 104 Tunisian patients]

Abstract

Introduction: Bipolar disorder affects many psychosocial and functional aspects, leading to a real social handicap and an alteration in quality of life.

Aim of the study: To evaluate bipolar patients' quality of life and to identify the risk factors responsible for a deterioration.

Design: Our cross-sectional study lasted for four months and included 104 bipolar patients treated at the psychiatry consultation of the university hospital in Mahdia. The data were collected through a questionnaire composed of 52 items exploring the general characteristics of subjects, the clinical and evolutional characteristics of bipolar disorder and providing information on the treatment. Quality of life was measured using the SF-36 (Short form) generic scale. A global average score was calculated and it was considered that quality of life was altered if the score was less than 66.7, according to the threshold value of Léan. Moreover, an average score was calculated for each dimension, thus permitting us to identify those most affected. We standardized initial average scores.

Results: The assessment of quality of life revealed a global average of 52.2 and an alteration in 78.8% of patients. The study of the dimensional average scores revealed that all dimensions were affected. The standardization also revealed deterioration in all dimensions, the mental component being particularly more affected than the physical component with respectively estimated scores of 31.7 and 40.5. The analytic approach concerned the relationship between qualitative and quantitative variables and the occurrence of an alteration in quality of life. For this effect, a bivariate study displayed a statistically significant correlation between the eight dimensions of the SF-36 and 8 variables. In order to take into account the relationships that link each variable to the others, and to avoid the bias of the bivariate study, a logistic regression analysis was performed. Only 4 variables with discriminating weight emerged from this analysis. According to the number of dimensions affected, the following factors were classified in decreasing order: absence of leisure activities, lack of stable budgetary resources, absence of professional activity and the association of a psychotropic medication.

Conclusion: This clinimetric approach permitted us to consider the global life of each patient suffering from bipolar disorder.

Keywords: Assessment; Bipolar disorder; Facteurs de risque; Quality of life; Qualité de vie; Risk factors; SF-36; Trouble bipolaire; Évaluation.