Psychiatric comorbid conditions may impact quality of life in bipolar disorder

Patients with greater clinical symptom severity had lower quality of life and higher functional impairment.
Patients with greater clinical symptom severity had lower quality of life and higher functional impairment.

Depression, irritability, and psychiatric comorbid conditions negatively impact quality of life and functioning in bipolar disorder, according to a study published in the International Journal of Bipolar Disorders.

Louisa G. Sylvia, PhD, Harvard Medical School, and colleagues explored the association of demographic and clinical features with quality of life and functioning in individuals with bipolar disorder. A total of 482 participants were enrolled across 11 study sites for a comparative effectiveness trial. The main inclusion criteria were being at least 18 years of age; having a primary diagnosis of bipolar I or II disorder; and being at least mildly symptomatic.

The participants were randomly assigned to received lithium or quetiapine in addition to adjunctive personalized treatment for 6 months. At baseline, the mean quality of life score was 44.3, and the mean functioning (LIFE-RIFT) score was 14.2. On average, females had lower quality of life than males. Patients who were married, living as married, divorced, or separated had worse functional impairment (higher scores on LIFE-RIFT) compared with patients who were single or never married. Age, ethnicity, and race were not significantly related to quality of life or functioning.

Patients with greater clinical symptom severity had lower quality of life and higher functional impairment. 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.

All psychiatric comorbid conditions, except substance use disorder, were significantly associated with worse quality of life. The total number of psychiatric comorbid conditions was associated with quality of life and functioning, such that for each additional comorbid condition, the mean quality of life decreased by 3.8 points and the mean functional impairment increased by 0.7 points.

“These data suggest that better interventions for individuals with social disadvantage, depression, and irritability are needed as they may be at greater risk for improvement in quality of life and functioning,” the authors stated.

Reference

  1. Sylvia LG, Montana RE, Deckersbach T, et al. Poor quality of life and functioning in bipolar disorder. Int J Bipolar Disord. 27 March 2017. doi: 10.1186/s40345-017-0078-4 
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