Thomas Soumya P, Nisha A, Varghese P Joseph
Department of Psychiatry, MOSC Medical College, Kolenchery, Kerala, India.
Indian J Psychol Med. 2016 Jul-Aug;38(4):336-40. doi: 10.4103/0253-7176.185941.
Despite significant advances in pharmacological and psychological therapies for bipolar disorder, many people continue to have less than optimal outcomes, which are associated with significant disability and poor quality of life (QOL). This study aimed to assess the disability and QOL and factors associated with such suboptimal outcomes in subjects with bipolar disorder in remission.
Consecutive patients diagnosed to have bipolar disorder in remission attending the Department of Psychiatry, MOSC Medical College, Kerala, India were recruited for the study. They were assessed using the International Classification of Diseases Diagnostic Criteria for Research-10, Hamilton Scale for Depression, Young's Mania Rating Scale, World Health Organization-QOL (WHO QOL-BREF), WHO-Disability Assessment Scale (WHO-DAS), and Kuppuswamy's scale for socioeconomic status assessment.
Eighty-four patients were evaluated. The mean total WHO-DAS score was 19.2 ± 2.09, the maximum disability in domain 4 (getting along) followed by domain 2 (mobility). The mean total WHO-QOL BREF score was 54.26 ± 2.85, the lowest subscore in domain 3 (social interactions). Disability scores were significantly associated with increasing age, female gender, not being an earning member of the family, and lower QOL scores. Poorer QOL scores were significantly associated with increasing age and higher disability score.
Many bipolar patients in remission have significant disability and poorer QOL. There is a need for longitudinal studies to explore such associations and develop interventions to reduce the disability thereby enhancing the QOL.
尽管双相情感障碍的药物治疗和心理治疗取得了显著进展,但许多人的治疗效果仍不尽人意,这与严重的残疾和生活质量低下相关。本研究旨在评估缓解期双相情感障碍患者的残疾状况、生活质量以及与此类欠佳治疗效果相关的因素。
连续招募印度喀拉拉邦莫斯科特医学院精神病科确诊为缓解期双相情感障碍的患者参与研究。使用《国际疾病分类研究用诊断标准第10版》、汉密尔顿抑郁量表、杨氏躁狂评定量表、世界卫生组织生活质量量表(WHO QOL - BREF)、世界卫生组织残疾评定量表(WHO - DAS)以及库普苏瓦米社会经济地位评估量表对他们进行评估。
共评估了84例患者。WHO - DAS总均分是19.2 ± 2.09,领域4(人际交往)的残疾程度最高,其次是领域2(活动能力)。WHO QOL - BREF总均分是54.26 ± 2.85,领域3(社会关系)的得分最低。残疾评分与年龄增长、女性、非家庭经济支柱以及较低的生活质量评分显著相关。较差的生活质量评分与年龄增长和较高的残疾评分显著相关。
许多缓解期双相情感障碍患者存在严重残疾且生活质量较差。需要开展纵向研究以探究此类关联,并制定干预措施以减少残疾,从而提高生活质量。