Quality of Life And Disability of Patients With Bipolar Disorder According To Treatment Response

Abstract

Bipolar Disorder (BD) is a lifelong, chronic mental illness with recurrent depressive, manic, hypomanic, or mixed episodes, with euthymic periods between episodes. The inadequate response is defined as the ineffectiveness of the drug from two different groups, despite being used sufficient dose and duration for the specific attack of the disease. BD is also related to impairment in functionality and disability. Most studies have demonstrated marked deterioration of quality of life and disability in patients with BD, even if they are clinically considered euthymic. Our study aims to determine the factors affecting the response to treatment and compare the quality of life and disability in patients with bipolar disorder. Our study included 150 patients with BD between 18-65 years who applied to the Dicle University Faculty of Medicine Psychiatry Clinic. Patients were divided into two groups according to treatment response. Sociodemographic Data Form, Clinical Global Impression Scale (CGI), Sheehan Disability Scale (SDS), World Health Organization Quality of Life Scale (WHOQOL-27) were applied to the participants. Inadequate response group had higher mood episodes, number of hospitalization, inadequate family support, non-adherence to treatment, suicide attempt, psychiatric comorbidity, late-onset treatment, and higher mean CGI-S and SDS subscales scores and lower mean WHOQOL-BREF 27 score. Inadequate response to treatment was associated with worse functionality and disability. Inadequate response related factors such as misdiagnosis, late diagnosis, late treatment, low adherence to treatment, missed psychiatric comorbidity, and inadequate family support should be minimized. Treatment should aim not only to remission symptoms but also aim complete functional recovery and no disability in work, social life, and family life/home responsibilities.