Department of Psychiatry, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Bipolar Disord. 2012 Feb;14(1):6-18. doi: 10.1111/j.1399-5618.2011.00969.x.
Health-related quality of life (HRQOL) refers to an individual's overall sense of wellbeing, and subjective physical, psychological, and social functioning. HRQOL is significantly affected in patients with bipolar disorder (BD), a chronic affective disorder characterized by mood fluctuations, sleep and cognitive impairment, and impact on inter-personal relationships, all of which contribute to HRQOL impairment. This article reviews the relevant literature on the potential causes and magnitude of HRQOL impairment in BD and role of treatment interventions in restoring HRQOL in this patient population.
A systematic database search was conducted using Medline, Cochrane Database of Systematic Reviews, and PsycINFO from 1959 to 2010 with the key words: bipolar disorder, mania, quality of life, and wellbeing health-related quality of life. A total of 52 studies were initially identified, leading to the selection of 30 studies that focused on measurement of quality of life in adult population.
While there is no one standard assessment of HRQOL, most measures incorporate a broad range of questions regarding the patient's own valuation of their physical, psychological, and social wellbeing. Three main findings are highlighted: (i) BD results in impairment of HRQOL compared to healthy individuals and variable negative impact as compared to other chronic psychiatric and medical conditions; (ii) comorbidities of BD have a further multi-factorial negative impact on HRQOL; and (iii) various pharmacological and non-pharmacological treatment modalities have a positive or equivocal effect on HRQOL in BD.
HRQOL is significantly adversely affected in BD patients. Additionally, the presence of comorbid conditions highly prevalent in BD further decreases HRQOL for these patients. In spite of these factors, this review offers renewed hope as several treatment regimens correlate with higher post-intervention HRQOL scores.
健康相关生活质量（HRQOL）是指个体的整体幸福感，以及主观的身体、心理和社会功能。双相情感障碍（BD）患者的 HRQOL 受到显著影响，BD 是一种慢性情感障碍，其特征为情绪波动、睡眠和认知障碍，以及对人际关系的影响，所有这些都会导致 HRQOL 受损。本文综述了 BD 患者 HRQOL 受损的潜在原因和程度，以及治疗干预在恢复该患者群体 HRQOL 中的作用。
使用 Medline、Cochrane 系统评价数据库和 PsycINFO 从 1959 年至 2010 年进行系统数据库搜索，关键词为：双相情感障碍、躁狂、生活质量、幸福感、健康相关生活质量。最初确定了 52 项研究，其中有 30 项研究主要集中在成年人群体的生活质量测量上。
虽然没有一个 HRQOL 的标准评估，但大多数评估方法都包含了广泛的问题，涉及患者自身对身体、心理和社会幸福感的评价。有三个主要发现：（i）BD 导致 HRQOL 受损，与健康个体相比存在差异，与其他慢性精神和医学疾病相比存在不同程度的负面影响；（ii）BD 的合并症对 HRQOL 产生了进一步的多因素负面影响；（iii）各种药物和非药物治疗方式对 BD 患者的 HRQOL 具有积极或不确定的影响。
BD 患者的 HRQOL 受到显著影响。此外，BD 中常见的合并症的存在进一步降低了这些患者的 HRQOL。尽管存在这些因素，但本次综述提供了新的希望，因为几种治疗方案与较高的干预后 HRQOL 评分相关。
