Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I Innsbruck, Austria.
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I Innsbruck, Austria.
J Affect Disord. 2018 Oct 1;238:399-404. doi: 10.1016/j.jad.2018.05.055. Epub 2018 May 29.
Improving Quality of Life (QoL) is an important objective in the treatment of bipolar disorder. The aim of the current study was to examine to which extent resilience, internalized stigma, and psychopathology are correlated to QoL.
We recruited 60 outpatients diagnosed with bipolar I disorder according to DSM-IV criteria and 77 healthy control subjects from the general community. In patients, symptoms were quantified by the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Young Mania Rating Scale (YMRS) and internalized stigma by the Internalized Stigma of Mental Illness (ISMI) scale. In order to assess QoL and resilience, the Berliner Lebensqualitätsprofil (BELP) and the Resilience Scale (RS-25) were used in both patients and control subjects.
Despite presenting with a very mild symptom level and relatively low internalized stigma, patients with bipolar I disorder indicated significantly lower QoL and resilience as compared to healthy control subjects. In patients, QoL correlated significantly with resilience, internalized stigma, and residual symptoms of depression. No significant correlations were observed between QoL and residual manic symptoms.
The cross-sectional design and the relatively small sample size limit the generalizability of our results. Furthermore, levels of resilience and internalized stigma may change over the course of the illness and have different impacts on the long-term outcome of patients with bipolar disorder.
Our results show that QoL of patients suffering from bipolar I disorder, even when only mildly ill, is strongly associated with the degree of resilience and internalized stigma, and that particularly residual depressive symptoms have a negative impact on QoL. In addition to drug treatment, psychotherapeutic approaches should be applied to strengthen resilience, to reduce internalized stigma, and, ultimately, to improve quality of life.
提高生活质量（QoL）是治疗双相情感障碍的一个重要目标。本研究旨在探讨韧性、内化污名和精神病理学与 QoL 的相关性。
我们招募了 60 名根据 DSM-IV 标准诊断为双相 I 型障碍的门诊患者和 77 名来自普通社区的健康对照者。在患者中，症状通过蒙哥马利-阿斯伯格抑郁评定量表（MADRS）和杨氏躁狂评定量表（YMRS）进行量化，内化污名通过内化精神疾病污名量表（ISMI）进行量化。为了评估 QoL 和韧性，在患者和对照组中使用了柏林生活质量问卷（BELP）和韧性量表（RS-25）。
尽管患者表现出非常轻微的症状水平和相对较低的内化污名，但与健康对照组相比，他们的 QoL 和韧性明显较低。在患者中，QoL 与韧性、内化污名和抑郁残留症状显著相关。QoL 与残留躁狂症状之间未观察到显著相关性。
横断面设计和相对较小的样本量限制了我们结果的普遍性。此外，韧性和内化污名的水平可能会随着疾病的发展而变化，并对双相情感障碍患者的长期预后产生不同的影响。
我们的结果表明，即使病情轻度发作，患有双相 I 型障碍的患者的 QoL 与韧性和内化污名的程度密切相关，并且残留的抑郁症状对 QoL 有负面影响。除了药物治疗外，还应应用心理治疗方法来增强韧性、减少内化污名，最终提高生活质量。
