Vol 2 - Iss 2 - Article - Quality of life as outcome variable in bipolar patients after long-term course #90

Quality of life as outcome variable in bipolar patients after long-term course Andreas Marneros Martin Luther University Halle-Wittenberg, Psychiatric Clinic Correspondence and requests for reprints should be addressed to: Professor A Marneros Martin-Luther-Universität Halle-Wittenberg Klinik und Poliklinik für Psychiatrie und Psychotherapie Julius-Kühn-Str. 7 06097 Halle Germany E-mail: andreas.marneros@medizin.uni-halle.de Telephone: +49 345 557 3651 Fax: +49 345 557 3607 Word count: 2617 Conflicts of interest: none Abstract In recent years, a growing interest in the quality of life of patients with bipolar and other affective disorders can be observed. Some studies concentrate on the quality of life immediately after an episode or during the short-term course. However, bipolar disorders are usually life-long disorders. Thus, an impact on the quality of life immediately after an episode can in some way be expected, as it can be in almost all episodes of mental and physical diseases. The longitudinal level of quality of life is much more important for the patients and their families. Additionally, it is somewhat artificial to separate the quality of life from other aspects of outcome, such as limitations in occupational and social life or impairment of autarky. Disabilities, impairments, social consequences and the quality of life of bipolar and other affective patients are also of theoretical relevance. As it is well known, in the initial phase of the dichotomy of the so-called “endogenous psychoses” (that means schizophrenia and affective disorders), Emil Kraepelin postulated that one of the most important differentiations between these two groups of mental diseases is the outcome, assuming that affective disorders have a favourable outcome, whereas schizophrenic disorders have a deteriorating course and outcome. The clinical experience and the long-term reality, however, revised Kraepelins views and he corrected himself. In one of his last publications Kraepelin himself pointed out that there are a lot of overlaps between affective and schizophrenic disorders, also with regard to the outcome. Research of the last 30 years has shown that many patients with bipolar disorders do have an unfavourable outcome. How frequent the unfavourable outcome is depends on the aspect of outcome investigated. It seems that the factors most crucially affecting the quality of life are the social consequences of the disorder, especially loss of job and premature retirement. Although the higher age in bipolar patients seems to be a factor correlated with a low quality of life, it can be assumed that high age alone is not necessarily related with low quality of life, but only in co-existence with physical diseases. In contrast, young age is not always associated with a high quality of life. Comorbidity with substance abuse is a very high risk for a low quality of life, especially in young bipolar patients. Another point having a negative impact on the quality of life of bipolar patients is related with mental health dependent retirement. It seems that the retirement due to mental disorders depends on social conditions as well, especially on unemployment in the general population and on missing supporting systems. The quality of life of bipolar patients could be improved by a consequent treatment and better social support. Key words: quality of life, bipolar disorder, prognosis, subjective/objective aspects, disability pension Details   Price: €10.00 Options   Quantity 1 (this product is downloadable)  Add to cart

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