Quality of life in unipolar depressive and bipolar affective patients

Objective: To assess subjective quality of life (QOL) of subjects with unipolar depressive and bipolar affective disorders. Methods: 153 consecutive psychiatric in-patients were assessed with standardized interviews. Prior to discharge QOL was assessed with WHOQOL-bref With the help of multivariate statistics, the effect of illness and biographical factors on four domains of QOL (physical health, psychological, social relationships and environment) was analyzed. Results: 103 patients suffered from unipolar depression, 51 from bipolar affective disorder (30 fulfilled criteria for a mixed or pure manic episode). With the exception of the domain environment for (mixed) manic patients, all patients reported lower QOL in all domains than was reported for the general population according to the German test manual. Multivariate analyses revealed that the chosen variables explained between 11.1% (social relationships) and 33.6% (psychological) of the variance of the QOL domains. The domains psychological" and environment" were first of all explained by the presence of a (mixed) manic episode, while the best variable to predict physical health" was presence of comorbid neurotic disorder. The depression score had little additional effects on QOL. Conclusions: We found little support that the QOL domains of the WHOQOL-bref in affective disorder are only hidden depression scores, as has been argued before. Therefore, QOL could be an interesting construct to better understand differences between subjective evaluation and (supposedly) objective psychopathology in bipolar affective disorders.