Quality of life and disability: a study on bipolar disorder patients in remission
Keywords:Bipolar I disorder, QoL, Disability, Pathway of care
Background: Throughout the world bipolar disorder is one of the leading causes of mental disability. But there are only few literature studies found on quality of life (QoL) and disability of patients with bipolar disorder. The study aims to assess inter-relationship between QoL and disability of patients with bipolar I disorder in remission and to assess the pathways of help seeking behaviors by the family members of bipolar I disorder patients.
Methods: This study involves non-experimental research design with purposive sampling method. A total of 62 participants from clinical group (outpatient department of mental health institute (Centre of excellence), S. C. B. medical college) and 48 participants from matched healthy control group included. World health organization quality of life assessment (WHO-QoL) Bref Odia version and WHO disability assessment schedule (WHO DAS) 2.0 used.
Results: Statistically significant differences (p<0.05) were found in all the four domains of QoL. Statistically significant differences (p<0.05) were found in cognition, mobility, life activity and participation in society domains of WHO DAS. There were significant negative correlations found in different domains of QoL and disability. A majority of family members consulted mental health professionals directly as the first modality of treatment.
Conclusions: Both the QoL and mental disability burden are equally affected in chronic suffers of bipolar I disorder, which requires mental health intervention at earliest as possible.
Murray CJ, Vos T, Lozano R, Naghav M, Flaxman AD, Michaud C, et al. Disability‑adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990‑2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380:2197‑223.
Weissman MM, Bland RC, Canino GJ, Faravelli C, Greenwald S, Hwu HG, et al. Cross‑national epidemiology of major depression and bipolar disorder. JAMA. 1996;276:293‑9.
Dean BB, Gerner D, Gerner RH. A systematic review evaluating health‑related quality of life, work impairment, and healthcare costs and utilization in bipolar disorder. Curr Med Res Opin. 2004;20:139‑54.
Swain SP, Behura SS. A comparative study of quality of life and disability among schizophrenia and obsessive-compulsive disorder patients in remission. Ind Psychiatry J. 2016;25:210-5.
The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med. 1995;41:1403‑9.
Arnold LM, Witzeman KA, Swank ML, McElroy SL, Keck PE Jr. Health‑related quality of life using the SF‑36 in patients with bipolar disorder compared with patients with chronic back pain and the general population. J Affect Disord. 2000;57:235‑9.
Cotrena C, Branco LD, Kochhann R, Shansis FM, Fonseca RP. Quality of life, functioning and cognition in bipolar disorder and major depression: A latent profile analysis. Psychiatry Res. 2016;241:289‑96.
Leidy NK, Palmer C, Murray M, Robb J, Revicki DA. Health‑related quality of life assessment in euthymic and depressed patients with bipolar disorder. Psychometric performance of four self‑report measures. J Affect Disord. 1998;48:207‑14.
Namjoshi MA, Buesching DP. A review of the health‑related quality of life literature in bipolar disorder. Qual Life Res. 2001;10:105‑15.
Harvey PD, Wingo AP, Burdick KE, Baldessarini RJ. Cognition and disability in bipolar disorder: Lessons from schizophrenia research. Bipolar Disord. 2010;12:364‑75.
Murray CJ, Lopez AD. The Global Burden of Diseases: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries and Risk Factors in 1990 and Projected to 2020. Boston: Harvard School of Public Health. World Health Organization and World Bank. 1996;325.
Goswami U, Sharma A, Khastigir U, Ferrier IN, Young AH, Gallagher P, et al. Neuropsychological dysfunction, soft neurological signs and social disability in euthymic patients with bipolar disorder. Br J Psychiatr. 2006;188:366‑73.
Sylvia LG, Montana RE, Deckersbach T, Thase ME, Tohen M. Poor quality of life and functioning in bipolar disorder. Int J Bipolar Disord. 2017;5:10.
Brennan S, Williams L, Berk M, Pasco J. Socioeconomic status and quality of life in population-based Australian men:data from the Geelong Osteoporosis study. Aust NZ J Public Health. 2013;37(3):226-32.
Beusenberg M, Orley J, World Health Organization. Division of Mental Health. A User's guide to the self-reporting questionnaire. World Health Organization. 1994. Available at: https://apps.who.int/iris/handle/10665/61113. Accessed on 25 August, 2022.
Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatr. 1960;23:56‑62.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: Reliability, validity and sensitivity. Br J Psychiatr. 1978;133:429‑35.
Wani RT. Socioeconomic status scales-modified Kuppuswamy and Udai Pareekh's scale updated for 2019. J Family Med Primary Care. 2019;8:1846-9.
WHOQOL group. Development of the World Health Organization WHOQOL-BREF Quality of life assessment. Psychological Med. 1998;28:551-8.
Kar N, Swain SP, Patra S, Kar B. The WHOQOL-BREF: Translation and Validation of the Odia Version in a Sample of Patients with Mental Illness. Ind J Social Psychiatr. 2017;33(3):269-73.
WHO Disability Assessment Schedule 2.0 (WHODAS 2.0). WHO. Available at: http://www.who.int/classifications/icf/whodasii/en/. Accessed on 25 August, 2022.
Thomas SP, Nisha A, Varghese PJ. Disability and quality of life of subjects with bipolar affective disorder in remission. Indian J Psychol Med. 2016;38:336-40.
Tharoor H, Chauhan A, Sharma PS. A cross‑sectional comparison of disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder with and without comorbid chronic medical illness. Ind J Psychiatr. 2008;50:24‑9.
Chacko D, Narayan KT, Prabhavathy KS. Disability in patients with bipolar and recurrent depressive disorder in remission: A comparative study. Ind J Psychol Med. 2011;33:49‑53.
Tharoor H, Narasimhana SPS, Chauhan A. Disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder. Ger J Psychiatr. 2007;10:111-6.
Sahu A, Patil V, Purkayastha S, Pattanayak RD, Sagar R. Pathways to care for patients with Bipolar I disorder: An exploratory study from a tertiary care centre of North India. Indian J Psychol Med. 2019;41:68-74.