Quality of life in stabilized outpatients with bipolar I disorder: Associations with resilience, internalized stigma, and residual symptoms

被引:42
作者
Post, Fabienne [1 ]
Pardeller, Silvia [1 ]
Frajo-Apor, Beatrice [1 ]
Kemmler, Georg [1 ]
Sondermann, Catherine [1 ]
Hausmann, Armand [1 ]
Fleischhacker, W. Wolfgang [1 ]
Mizuno, Yuya [2 ,3 ]
Uchida, Hiroyuki [2 ]
Hofer, Alex [1 ]
机构
[1] Med Univ Innsbruck, Dept Psychiat Psychotherapy & Psychosomat, Div Psychiat 1, Innsbruck, Austria
[2] Keio Univ, Sch Med, Dept Neuropsychiat, Tokyo, Japan
[3] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychosis Studies, London, England
关键词
Bipolar disorder; Quality of life; Resilience; Internalized stigma; MENTAL-ILLNESS; THE-LITERATURE; SELF-ESTEEM; SCHIZOPHRENIA; DEPRESSION; HEALTH; PEOPLE; SCALE; IMPACT; INTERVENTIONS;
D O I
10.1016/j.jad.2018.05.055
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objectives: 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. Methods: 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-Asberg 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 Lebensqualitatsprofil (BELP) and the Resilience Scale (RS-25) were used in both patients and control subjects. Results: 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. Limitations: 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. Conclusion: 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.
引用
收藏
页码:399 / 404
页数:6
相关论文
共 57 条
[1]  
[Anonymous], 2009, RS14-Resilience Scale 14-items
[2]   Health-related quality of life using the SF-36 in patients with bipolar disorder compared with patients with chronic back pain and the general population [J].
Arnold, LM ;
Witzeman, KA ;
Swank, ML ;
McElroy, SL ;
Keck, PE .
JOURNAL OF AFFECTIVE DISORDERS, 2000, 57 (1-3) :235-239
[3]   SOCIAL-ADJUSTMENT OF REMITTED BIPOLAR AND UNIPOLAR OUT-PATIENTS - A COMPARISON WITH AGE-MATCHED AND SEX-MATCHED CONTROLS [J].
BAUWENS, F ;
TRACY, A ;
PARDOEN, D ;
VANDERELST, M ;
MENDLEWICZ, J .
BRITISH JOURNAL OF PSYCHIATRY, 1991, 159 :239-244
[4]   Stage managing bipolar disorder [J].
Berk, Michael ;
Berk, Lesley ;
Dodd, Seetal ;
Cotton, Sue ;
Macneil, Craig ;
Daglas, Rothanthi ;
Conus, Philippe ;
Bechdolf, Andreas ;
Moylan, Steven ;
Malhi, Gin S. .
BIPOLAR DISORDERS, 2014, 16 (05) :471-477
[5]   Impact of bipolar disorder on a US community sample [J].
Calabrese, JR ;
Hirschfeld, RMA ;
Reed, M ;
Davies, MA ;
Frye, MA ;
Keck, PE ;
Lewis, L ;
McElroy, SL ;
McNulty, JP ;
Wagner, KD .
JOURNAL OF CLINICAL PSYCHIATRY, 2003, 64 (04) :425-432
[6]   Stigma: a core factor on predicting functionality in bipolar disorder [J].
Cerit, Cem ;
Filizer, Arzu ;
Tural, Umit ;
Tufan, Ali Evren .
COMPREHENSIVE PSYCHIATRY, 2012, 53 (05) :484-489
[7]   Quality of life and its correlates in patients with bipolar disorder stabilized on lithium prophylaxis [J].
Chand, PK ;
Mattoo, SK ;
Sharan, P .
PSYCHIATRY AND CLINICAL NEUROSCIENCES, 2004, 58 (03) :311-318
[8]   Resilience and impulsivity in euthymic patients with bipolar disorder [J].
Choi, Jae-Won ;
Cha, Boseok ;
Jang, Jihoon ;
Park, Chul-Soo ;
Kim, Bong-Jo ;
Lee, Cheol-Soon ;
Lee, So-Jin .
JOURNAL OF AFFECTIVE DISORDERS, 2015, 170 :172-177
[9]   A POWER PRIMER [J].
COHEN, J .
PSYCHOLOGICAL BULLETIN, 1992, 112 (01) :155-159
[10]   Well-being and functioning in patients with bipolar disorder assessed using the MOS 20-ITEM short form (SF-20) [J].
Cooke, RG ;
Robb, JC ;
Young, LT ;
Joffe, RT .
JOURNAL OF AFFECTIVE DISORDERS, 1996, 39 (02) :93-97