Quality of life in euthymic bipolar patients: A systematic review and meta-analysis

Background: Patients with bipolar disorder, even euthymic, could suffer an impairment in their quality of life compared to healthy controls. Since no previous systematic review and meta-analysis has been conducted, the aim of the current study is to conduct a systematic review and meta-analysis of cross-sectional case-controlled studies on quality of life in adult euthymic Bipolar Disorder patients. Methods: A systematic review and meta-analysis that followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) was conducted. Major electronic databases were searched on August 2018 to assess the variables associated with quality of life in euthymic bipolar disorder patients. After selecting case-control studies, data collection, quality assessment and subsequently statistical analysis were done. Results: 66 studies were finally selected for systematic review and meta-analysis. Four different quality of life instruments were used among the different studies. Effect size analysis showed that there were significant differences in quality of life outcomes between euthymic bipolar disorder patients and healthy controls (d= - 0.922; SE = 0.316; 95%CI = - 1.541- - 0.303; p = .004), with lower quality of life in the euthymic patients. Furthermore, time since euthymia explained 15.62% of variability, and age of control group explained 29.6% of variability. No other moderators were statiscally significant. Limitations: The instruments used were heterogeneous. Moreover, the role of other clinical moderators could not be included due to the lack of this information in most of the articles. Conclusions: Quality of life is lower in euthymic bipolar patients than in healthy controls. However, longer time in euthymia is associated with better outcomes.