Quality of life in persons at risk for bipolar disorder: a two year prospective-longitudinal observational cohort study (BipoLife)

Johanna Glaus¹, Anne Karow¹, Martin Lambert¹, Pia Sowada¹, Kyra Bröckel-Bundt², Christina Berndt², Cathrin Sauer², Georg Juckel³, Andreas J Fallgatter^{4

5}, Andreas Bechdolf⁶, Andreas Reif⁷, Silke Matura⁷, Sarah Kittel-Schneider^{8

9

10}, Thomas Stamm^{6

11}, Tilo Kircher¹², Irina Falkenberg¹², Andreas Jansen¹², Christoph U Correll^{13

14

15}, Paolo Fusar-Poli^{16

17

18

19}, Michael Bauer², Andrea Pfennig², Anja Christine Rohenkohl²⁰

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
² Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstrasse 74, 01307, Dresden, Germany.
³ Department of Psychiatry and Psychotherapy, LWL-University Hospital Bochum, Ruhr-University Bochum, Bochum, Germany.
⁴ Dept. of Psychiatry and Psychotherapy, University Hospital Tübingen, Osianderstr. 24, 72076, Tübingen, Germany.
⁵ German Center for Mental Health (DZPG), partner site, Tübingen, Germany.
⁶ Clinic for Psychiatry and Psychotherapy, Charité University Medicine Berlin, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Dieffenbachstr. 1, 10967, Berlin, Germany.
⁷ Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt am Main - Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany.
⁸ Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Würzburg Margarete-Höppel-Platz1, 97080, Würzburg, Germany.
⁹ Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, T12DC4A, Ireland.
¹⁰ APC Microbiome Ireland, University College Cork, College Road, Cork, T12 CY82, Ireland.
¹¹ Department of Psychiatry, Psychotherapy and Psychosomatic, Medical School Brandenburg, Neuruppin, Germany.
¹² Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Strasse 8, 35039, Marburg, Germany.
¹³ Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹⁴ Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
¹⁵ Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
¹⁶ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK.
¹⁷ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
¹⁸ Outreach and Support in South-London (OASIS) Service, South London and Maudlsey (SLaM) NHS Foundation Trust, London, UK.
¹⁹ Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany.
²⁰ Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany. a.rohenkohl@uke.de.

PMID: 39964389
PMCID: PMC11836254
DOI: 10.1186/s40345-025-00373-y

Quality of life in persons at risk for bipolar disorder: a two year prospective-longitudinal observational cohort study (BipoLife)

Johanna Glaus et al. Int J Bipolar Disord. 2025.

. 2025 Feb 18;13(1):7.

doi: 10.1186/s40345-025-00373-y.

Authors

Affiliations

¹ Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany.
² Department of Psychiatry and Psychotherapy, Faculty of Medicine, TUD Dresden University of Technology, Fetscherstrasse 74, 01307, Dresden, Germany.
³ Department of Psychiatry and Psychotherapy, LWL-University Hospital Bochum, Ruhr-University Bochum, Bochum, Germany.
⁴ Dept. of Psychiatry and Psychotherapy, University Hospital Tübingen, Osianderstr. 24, 72076, Tübingen, Germany.
⁵ German Center for Mental Health (DZPG), partner site, Tübingen, Germany.
⁶ Clinic for Psychiatry and Psychotherapy, Charité University Medicine Berlin, Vivantes Klinikum am Urban und Vivantes Klinikum im Friedrichshain, Dieffenbachstr. 1, 10967, Berlin, Germany.
⁷ Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt am Main - Goethe University, Heinrich-Hoffmann-Str. 10, 60528, Frankfurt am Main, Germany.
⁸ Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Würzburg Margarete-Höppel-Platz1, 97080, Würzburg, Germany.
⁹ Department of Psychiatry and Neurobehavioural Science, University College Cork, Acute Mental Health Unit, Cork University Hospital, Wilton, Cork, T12DC4A, Ireland.
¹⁰ APC Microbiome Ireland, University College Cork, College Road, Cork, T12 CY82, Ireland.
¹¹ Department of Psychiatry, Psychotherapy and Psychosomatic, Medical School Brandenburg, Neuruppin, Germany.
¹² Department of Psychiatry and Psychotherapy, Philipps-Universität Marburg, Rudolf-Bultmann-Strasse 8, 35039, Marburg, Germany.
¹³ Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹⁴ Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
¹⁵ Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
¹⁶ Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, King's College London, London, UK.
¹⁷ Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
¹⁸ Outreach and Support in South-London (OASIS) Service, South London and Maudlsey (SLaM) NHS Foundation Trust, London, UK.
¹⁹ Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany.
²⁰ Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52, 20246, Hamburg, Germany. a.rohenkohl@uke.de.

PMID: 39964389
PMCID: PMC11836254
DOI: 10.1186/s40345-025-00373-y

Abstract

Background: Improving quality of life (QoL) is important for the treatment of people with bipolar disorder (BD). Early-BipoLife is a German multicentre naturalistic, prospective-longitudinal observational cohort study investigating early recognition and intervention in people at increased risk of developing a BD. This analysis aims to investigate influencing factors and changes in QoL as a basis for the development of early intervention strategies in patients with at risk syndrome for BD.

Method: A cohort of 1086 participants (15-35 years) with at least one risk factor (EPIbipolar criteria) for BD was assessed over the course of 2 years. Changes in QoL (WHOQOL-BREF) were evaluated in a mixed model for repeated measures.

Results: Compared to an age-matched comparison group, people at risk for BD showed significant lower QoL in all domains at baseline. The overall QoL of the psychological well-being domain of the WHOQOL-BREF increased over the 2 year study course (p < 0.001). The bipolar risk group (EPIbipolar) change from baseline divided into (a) decreasing, (b) increasing and (c) constant risk group in the course of 2 years. Baseline risk group assignment was not a significant predictor of change in QoL over 2 years for any of the QoL domains, but participants with an increase in risk over the 2-year course had a significantly smaller gain in QoL than the group with constant risk (p = 0.014) or decreasing risk (p < 0.001). Higher levels of QoL were associated with a higher self-rated ability to use coping strategies. Moreover, a higher level of functioning (GAF) at baseline was positively correlated with improvement of different QoL domains after 2 years.

Conclusion: Patients with a risk syndrome for BD reported significantly reduced QoL compared to their age-matched comparison group. Risk status monitoring might be beneficial to identify individuals who could profit from an intervention to increase their QoL. Further studies promoting the development of coping strategies for successful self-management could be helpful to improve overall mental health and positively influence QoL.

Keywords: Bipolar disorder; Coping strategies; Early intervention; Early recognition; Life quality; Population at risk; Prevention; Prodromal symptoms; Quality of life; Risk level.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Trial registration: Improving Early Recognition and Intervention in At-risk Stages of Bipolar Disorders (BipoLife-A1), NCT02456545, Registered at 11 May 2015, https://clinicaltrials.gov/ct2/show/NCT02456545 . Consent for publication: Not applicable. Competing interests: PFP is supported by #NEXTGENERATIONEU (NGEU), funded by the Ministry of University and Research (MUR), National Recovery and Resilience Plan (NRRP), project MNESYS (PE0000006) – A Multiscale integrated approach to the study of the nervous system in health and disease (DN. 1553 11.10.2022). CB, MB, AP and PFP have received funding from the German Research Foundation (DFG) grant number GRK2773/1 – 454245598. MB has additionally received funding from Bundesministerium für Bildung und Forschung, and the European Commission. He served as a consultant to GH Research, Janssen-Cilag, neuraxpharm, Novartis, Shire International, Sunovion, and Takeda, and received fees from Aristo, Hexal, Janssen Cilag, and Sunovion. AR serves on advisory boards and receives speaker’s honoraria from Medice, Shire/ Takeda, Janssen, neuraxpharm, Servier and SAGE. SKS has received speaker’s honoraria from Taked, Medice and Janssen in the past 3 years. CU Correll has been a consultant and/or advisor to or has received honoraria from: AbbVie, Acadia, Alkermes, Allergan, Angelini, Aristo, Boehringer-Ingelheim, Cardio Diagnostics, Cerevel, CNX Therapeutics, Compass Pathways, Darnitsa, Gedeon Richter, Hikma, Holmusk, IntraCellular Therapies, Janssen/J&J, Karuna, LB Pharma, Lundbeck, J. Martini et al. European Neuropsychopharmacology 78 (2024) 43–53 52 MedAvante-ProPhase, MedInCell, Merck, Mindpax, Mitsubishi Tanabe Pharma, Mylan, Neurocrine, Newron, Noven, Novo Nordisk, Otsuka, Pharmabrain, PPD Biotech, Recordati, Relmada, Reviva, Rovi, Seqirus, SK Life Science, Sunovion, Sun Pharma, Supernus, Takeda, Teva, and Viatris. He provided expert testimony for Janssen and Otsuka. He served on a Data Safety Monitoring Board for Compass, Lundbeck, Relmada, Reviva, Rovi, Supernus, and Teva. He has received grant support from Janssen and Takeda. He received royalties from UpToDate and is also a stock option holder of Cardio Diagnostics, Mindpax, LB Pharma and Quantic. All other authors state to have no conflict of interest.

Figures

**Fig. 1**
Changes over time in QoL. *Mean values of the change in Quality of Life from baseline to Follow up 4 (FU4)

See this image and copyright information in PMC

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Quality of life in persons at risk for bipolar disorder: a two year prospective-longitudinal observational cohort study (BipoLife)

Affiliations

Quality of life in persons at risk for bipolar disorder: a two year prospective-longitudinal observational cohort study (BipoLife)

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

LinkOut - more resources

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