Abstract

Bipolar disorder is a chronic, typically early onsetting group of mental disorders with a lifelong risk of relapse. It is characterized by recurrent periods of depression and pathologically elevated mood consisting of increased energy and activity during which patients may experience sleep loss, over-confidence, impaired concentration, extreme talkativeness, and engage in irresponsible risk-taking behavior. As a result, it is often problematic to undertake usual activities and maintain interpersonal relationships (World Health Organization [WHO], 2001). An estimated 2.4% of the world’s population suffer from some form of bipolar disorder, with a lifetime prevalence of 0.6% for bipolar I disorder and 0.4% for bipolar II disorder, while 1.4% of the total population has a lifetime prevalence of subsyndromal bipolar disorder (Merikangas et al., 2011). Bipolar disorders are categorized into bipolar I and bipolar II depending on a patient history of major depressive and hypomanic episodes only (bipolar II), or depressive and manic episodes in addition to hypomanic and mixed episodes (bipolar I). Subsyndromal symptoms may be diagnosed as bipolar disorder not otherwise specified. Patients with bipolar disorder encounter many difficulties in leading a normal lifestyle, even with the support of family, friends and carers, and therefore tend to have a low quality of life (QoL), which is powerfully influenced by two factors: the nature of mental illness itself and treatment-related comorbidities. Features of social disability that may trouble patients with bipolar disorder include problems in developing and sustaining friendships and difficulties in maintaining intimate relationships with a partner. Furthermore, the inability to manage money, housework, and coping with an emergency (Kai and Crosland, 2001) impedes a normal lifestyle. Possibly as a consequence of poor QoL, “self

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