Zhang Hongwei, Wisniewski Stephen R, Bauer Mark S, Sachs Gary S, Thase Michael E
Epidemiology Data Center, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Compr Psychiatry. 2006 May-Jun;47(3):161-8. doi: 10.1016/j.comppsych.2005.08.001.
Evidence indicates that quality of life is subnormal in patients with bipolar disorder and that it differs across mood states. However, the pattern of specific deficits has not been well studied, and the role of potential confounders has received no attention.
We investigated the self-reported quality of life, Medical Outcomes Study 36-Item Short Form (SF-36), and Quality of Life Enjoyment and Satisfaction (QLESQ) at baseline across the clinical states of the first 2000 participants enrolled in Systematic Treatment Enhancement Program for Bipolar Disorder.
Bivariate analyses indicated significant differences across mood state, with depressive symptoms predicting lower SF-36 mental and physical scores and QLESQ overall score. However, adjustment for relevant clinical and demographic variables erased the difference in the SF-36 physical score. Notably, covariate adjustment removed the apparently "supranormal" SF-36 mental and QLESQ scores among those with mania/hypomania compared with those euthymic.
Depressive symptoms are a strong predictor of quality of life, yet covariate adjustment has an impact as well. Clinically, this indicates the need for addressing these factors if quality of life is to be maximized. Such factors should also be taken into account in future naturalistic and clinical trials research on quality of life in bipolar disorder.
有证据表明，双相情感障碍患者的生活质量低于正常水平，且在不同情绪状态下存在差异。然而，具体缺陷模式尚未得到充分研究，潜在混杂因素的作用也未受到关注。
我们对参加双相情感障碍系统治疗强化项目的前2000名参与者在基线时的自我报告生活质量、医学结局研究简明健康调查问卷（SF-36）以及生活质量享受与满意度问卷（QLESQ）进行了调查，这些调查涵盖了不同临床状态。
双变量分析表明，不同情绪状态之间存在显著差异，抑郁症状预示着SF-36心理和生理得分以及QLESQ总体得分较低。然而，对相关临床和人口统计学变量进行调整后，消除了SF-36生理得分的差异。值得注意的是，与心境正常者相比，协变量调整消除了躁狂/轻躁狂患者中SF-36心理得分和QLESQ得分明显“超常”的情况。
抑郁症状是生活质量的有力预测指标，但协变量调整也有影响。在临床上，这表明如果要使生活质量最大化，就需要解决这些因素。在未来关于双相情感障碍生活质量的自然主义和临床试验研究中，也应考虑这些因素。
