Poor quality of life and functioning in bipolar disorder

Louisa G Sylvia^{1

2}, Rebecca E Montana³, Thilo Deckersbach^{3

4}, Michael E Thase⁵, Maurcio Tohen⁶, Noreen Reilly-Harrington^{3

4}, Melvin G McInnis⁷, James H Kocsis⁸, Charles Bowden⁹, Joseph Calabrese¹⁰, Keming Gao¹⁰, Terence Ketter¹¹, Richard C Shelton¹², Susan L McElroy^{13

14}, Edward S Friedman¹⁵, Dustin J Rabideau¹⁶, Andrew A Nierenberg^{3

4}

Affiliations

¹ Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA, 02114, USA. lsylvia2@partners.org.
² Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. lsylvia2@partners.org.
³ Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA, 02114, USA.
⁴ Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
⁵ Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
⁶ Department of Psychiatry and Behavioral Sciences, University of New Mexico, Health Sciences Center, Albuquerque, NM, USA.
⁷ Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
⁸ Department of Psychiatry, Weill Cornell Medicine, New York City, NY, USA.
⁹ Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
¹⁰ Bipolar Disorders Research Center, University Hospital's Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
¹¹ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
¹² Department of Psychiatry, University of Alabama Birmingham School of Medicine, Birmingham, AL, USA.
¹³ Lindner Center of HOPE, Mason, OH, USA.
¹⁴ Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹⁵ University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹⁶ Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.

PMID: 28188565
PMCID: PMC5366290
DOI: 10.1186/s40345-017-0078-4

Poor quality of life and functioning in bipolar disorder

Louisa G Sylvia et al. Int J Bipolar Disord. 2017 Dec.

. 2017 Dec;5(1):10.

doi: 10.1186/s40345-017-0078-4. Epub 2017 Mar 27.

Authors

Affiliations

¹ Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA, 02114, USA. lsylvia2@partners.org.
² Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. lsylvia2@partners.org.
³ Department of Psychiatry, Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA, 02114, USA.
⁴ Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
⁵ Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
⁶ Department of Psychiatry and Behavioral Sciences, University of New Mexico, Health Sciences Center, Albuquerque, NM, USA.
⁷ Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
⁸ Department of Psychiatry, Weill Cornell Medicine, New York City, NY, USA.
⁹ Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
¹⁰ Bipolar Disorders Research Center, University Hospital's Case Medical Center, Case Western Reserve University, Cleveland, OH, USA.
¹¹ Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
¹² Department of Psychiatry, University of Alabama Birmingham School of Medicine, Birmingham, AL, USA.
¹³ Lindner Center of HOPE, Mason, OH, USA.
¹⁴ Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹⁵ University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹⁶ Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA.

PMID: 28188565
PMCID: PMC5366290
DOI: 10.1186/s40345-017-0078-4

Abstract

Background: This study explores the association of demographic and clinical features with quality of life and functioning in individuals with bipolar disorder.

Methods: Adult participants (N = 482) with bipolar I or II disorder were enrolled in a comparative effectiveness study across eleven study sites and completed baseline measures of medical and psychiatric history, current mood, quality of life, and functioning. Participants with at least mildly depressive or manic/hypomanic symptomatic severity were randomized to receive lithium or quetiapine in addition to adjunctive personalized treatment for 6 months.

Results: Participants with more severe depressive and irritability symptoms had lower quality of life and higher functional impairment. All psychiatric comorbid conditions except substance use disorder were associated with worse quality of life. On average, females had lower quality of life than males. Patients who were married, living as married, divorced, or separated had worse functional impairment compared with patients who were single or never married. A composite score of social disadvantage was associated with worse functioning and marginally associated with worse quality of life. Symptom severity did not moderate the effect of social disadvantage on quality of life or functioning.

Conclusions: Our findings highlight that depression, irritability, and psychiatric comorbid conditions negatively impact quality of life and functioning in bipolar disorder. The study suggests that individuals with social disadvantage are at risk for functional impairment. Trial Registration This study is registered with ClinicalTrials.gov. Identification number: NCT01331304.

Keywords: Bipolar disorder; Functioning; Quality of life; Social disadvantage.

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Figures

**Fig. 1**
Marginal and conditional effects of depression and irritability on quality of life and functioning. In this figure, we display the marginal (unadjusted) and conditional (adjusted for other covariate in model) effects of depressive and irritability symptom severity on quality of life and functioning. In both cases, the marginal and conditional effects of BISS depression were similar, while the effect of BISS irritability decreased when adjusting for BISS depression

See this image and copyright information in PMC

References

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Poor quality of life and functioning in bipolar disorder

Affiliations

Poor quality of life and functioning in bipolar disorder

Authors

Affiliations

Abstract

Figures

References

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical