Abstract
A sizable body of research has now examined the complex relationship between quality of life (QoL) and depressive disorder. Uptake of QoL research in relation to bipolar disorder (BD) has been comparatively slow, although increasing numbers of QoL studies are now being conducted in bipolar populations. We aimed to perform a review of studies addressing the assessment of generic and health-related QoL in patients with bipolar disorder.A literature search was conducted in a comprehensive selection of databases including MEDLINE up to November 2004. Key words included: bipolar disorder or manic-depression, mania, bipolar depression, bipolar spectrum and variants AND quality of life, health-related QoL, functional status, well-being and variants. Articles were included if they were published in English and reported on an assessment of generic or health-related QoL in patients with BD. Articles were not included if they had assessed fewer than 10 patients with BD, were only published in abstract form or only assessed single dimensions of functioning.The literature search initially yielded 790 articles or abstracts. Of these, 762 did not meet our inclusion criteria, leaving a final total of 28 articles. These were sub-divided into four categories (assessment of QoL in patients with BD at different stages of the disorder, comparisons of QoL in Patients with BD with that of other patient populations, QoL instrument evaluation in patients with BD and treatment studies using QoL instruments to assess outcome in Patients with BD) and described in detail.The review indicated that there is growing interest in QoL research in bipolar populations. Although the scientific quality of the research identified was variable, increasing numbers of studies of good design are being conducted. The majority of the studies we identified indicated that QoL is markedly impaired in patients with BD, even when they are considered to be clinically euthymic. We identified several important avenues for future research, including a need for more assessment of QoL in hypo/manic patients, more longitudinal research and the development of a disease-specific measure of QoL for patients with BD.
Highlights
The review indicated that there is growing interest in quality of life (QoL) research in bipolar populations
The authors concluded that deficits in health-related quality of life' (HRQOL) in patients with bipolar disorder (BD) are similar to those observed in patients with unipolar depression and equal or lower than levels of HRQOL observed in patients with other chronic medical conditions
Four of these were generated by a research group in Canada, and will be dealt with in unison
Summary
The review indicated that there is growing interest in QoL research in bipolar populations. The World Health Organization has described QoL as "individuals' perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns" [1] This broad, generic conceptualization of QoL can be distinguished from the more specific concept of 'health-related quality of life' (HRQOL), which refers to those aspects of an individual's life that impact directly upon their health [2] and the more economically-derived 'cost-utility' models of QoL. This area of research is further complicated by the understanding that QoL can be highly subjective, potentially fluid and open to distortion, making it challenging to measure reliably and accurately. Given the recent upsurge of interest in describing QoL in BD, the present study aimed to provide an updated literature review of studies that have assessed both generic and HRQOL in patients with bipolar disorder
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