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• W2783200203 abstract "Abstract : Quality of life in patients with bipolar disorder under Remission in relation to clinical variables andPsychosocial factors. Background :Bipolar Disorder is a chronic psychiatric disorder with characteristic manicAnd depressive episodes. It occurs in both male and female equally and resulting inImpairment of quality of life (QOL) in them at various degrees during remission.Methods:Fifty numbers of bipolar disorder patients under remission from the casesAttending outpatients unit of the tertiary care hospital for regular follow up wereSelected. Age and sex matched healthy individuals were selected as controls. ASemi structured proforma was administered to collect sociodemographic profile ofThe samples. Hamilton Depression Rating Scale (HDRS) and Young Mania RatingScale (YMRS) were employed to ensure that the patients were under remission.The quality of life was assessed with WHOQOL-Bref scale. The clinicalInformation such as age of onset, duration of illness, number of episodes wereRecorded and rating scales such as Presumptive Stressful Life EventsScale(PSLES), Multidimensional Scale of Perceived Social Support(MSPSS) andHassles scale were employed. The changes in the quality of life were determinedWith WHOQOL-Bref scale score as dependent variable and other recordings suchAs sociodemographic profile, rating scale scores and clinical variables asIndependent variables using regression analysis and correlation with software. TestOf significance was carried out wherever necessary.Result:The sociodemographic profile of the patients with higher percentage was asFollows. Married (64), education –SSLC (50), Hindus (82), income/ month 2000-4000 (62), nuclear family type (82) and rural background (82). The mean age atOnset, duration of illness, number of episodes, number of life events, life eventsScore, Hassles frequency, severity, intensity, HDRS, YMRS and MSPSS scoresFor the patients were 25.4, 12.2, 5.8, 2.04, 96.98, 38.98, 76.6, 1.92, 2.38, 0.58 and27.38 respectively. There was a significant (P<0.01) reduction in the WHOQOLScore of patients by about 23, 41, 24 and 18% on the physical, psychological,Social and environmental domains compared to healthy subjects. RegressionAnalysis of the HDRS score over WHOQOL score explained that higher HDRSScore significantly (P<0.01) influenced on all the domains of QOL with moreVariance on the psychological domain. Similarly, Hassles scale score explainedHigher variance on the psychological domain and lesser influence on remainingDomains of QOL score. However, YMRS score did not influence the QOL of thePatients. In this study patients received positive social support and the score wasPositively correlated with QOL. On the contrary, HDRS score was negativelyCorrelated (P<0.1).Conclusion:It may be concluded that QOL of bipolar patients under remission hadSignificantly lower compared to healthy individuals. The HDRS and Hassles scaleScores were strongly and significantly influenced QOL. On the other hand, patientsPerceived better positive support from the family.Introduction:Bipolar disorder (BD) is a mood disorder which involves extremeChanges in affect, cognition and behavior. It can affect people at any age andOccurs both in male and female equally. It is found in all races, ethnic groupsAnd across all social classes. The onset is generally late adolescence or earlyAdulthood with major implications on the person’s development and quality ofLife (QOL).Globally it has been ranked the ninth highest cause of years of life lostDue to death or disability and the fifth most prevalent cause of disabilityAmong individuals aged between 15 and 44 years (World Health Organisation,1995). It is now recognized as a major public health problem.Lifetime prevalence rates of bipolar disorder are about 4 per cent(Angst, 1998). A meta-analysis of 13 epidemiological studies which wereConducted in India estimated a prevalence rate of 2.2 to 3.3% for manicDepression (Venkataswamy, et al., 1998). However, in a recent review articleIt was stated that the prevalence of mental disorders reported inEpidemiological surveys considered lower estimates rather than accurateReflections of the true prevalence in the population due to its methodologicalFlaws (Suresh Bada Math et al., 2007).International Classification of Diseases (ICD-10) requires minimum ofTwo episodes out of which one must be mania, hypomania or mixed episode toDiagnose bipolar disorder. But in Diagnostic and statistical Manual 4th EditionText Revision (DSM-IV-TR) single manic, hypomanic and mixed episodesAre also classified as bipolar disorder. According to DSM-IV-TR, BipolarDisorder has been reported to have episodes of mania, hypomania, mixed,Depressed and unspecified and it also classifies severity levels into mild,Moderate, severe without psychosis and severe with psychosis. It comprises aSpectrum of disorders to include bipolar I, bipolar II, cyclothymia, andBipolar disorder not otherwise specified (NOS). The cyclical recurrence ofMood episodes including both depression and mood elevation is the definingFeature of any of these categories of bipolar disorderBipolar disorders are more recurrent and chronic in nature. Moreover,It can severely affect the quality of life and functioning, including work andProductivity at work. It is understood that Bipolar Disorder is associated withA higher level of functional impairment than previously assumed, particularlyWith regard to social adjustment and vocational functioning. Due to theCyclical nature of this illness, there is an impact on the social and functionalWell-being of the individual. Moreover, subsyndromal symptoms which arePresenting most of the time would eventually affect the quality of life.Of late, the issue of quality of life has received increasedAttention from the medical community due to its significant role inPatient rehabilitation (Lustig and Crowder, 2000).Quality of life is a multidimensional concept, encompassing differentAspects such as physical, emotional, social and spiritual wellbeing (Guyatt etAl., 1993). The World Health Organization (WHO) has described QOL as“individuals’ perception of their position in life in the context of the cultureAnd value systems in which they live and in relation to their goals,Expectations, standards and concerns”. This broad generic conceptualizationCan be distinguished from the more specific concept of Health Related QOL(HRQOL) which refers to those aspects of individual’s life that impactDirectly upon their health.In absence of a disease-specific instrument for measuring QOL inBipolar patients, many earlier authors have used World Health OrganizationQuality of Life Scale (WHOQOL-BREF), Medical Outcome Study- ShortForm (SF-36), Quality of Life Enjoyment and Satisfaction Questionnaire(Q-LES-Q), Quality of Life Index (QLI), euroqol:5 Dimensions (EQ-5D)Scale and Quality of Life Inventory for assessing the QOL in bipolar patients.QOL has been impaired in bipoar patients during different phases ofDisorder and has been associated with poor work, social and family life(Gazalle et al., 2006).Impaired QOL have also been observed in remitted patients(macqueen et al., 2000; Gazalle et al., 2007). Moreover, euthymic bipolarPatients had reduced cognitive functions which resulted in poor socialOutcome (Burdick et al., 2010). Several euthymic bipolar patients haveRemarkable dysfunction in the cognition and contribute to the patientsFunctioning. Previous published works shows that neurocognitive deficits areThe strong predictors of functional capacity. Neurocognitive defects are theImpairments in the ability of the functioning of the brain areas, neuralPathways.. In addition to biological and genetic factors, life events and otherPsychosocial factors clearly play a role in the development of BipolarDisorder. These psychosocial factors also play a role in the relapse of theIllness and modifying the course of the disorder.Knowledge about the clinical predictors and understanding theFactors related to quality of life of the patients would help us to design specificClinical interventions for this otherwise a devastating disorder.In our country, the assessment of QOL and the factors contributingTo it in bipolar patients under remission has not been studied in detail. Hence,The present study was carried out to evaluate the quality of life in bipolarPatients under remission and its relation to certain clinical variables andPsychosocial factors." @default.
• W2783200203 created "2018-01-26" @default.
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• W2783200203 date "2013-04-01" @default.
• W2783200203 modified "2023-09-27" @default.
• W2783200203 title "Quality of Life in Patients with Bipolar Disorder Under Remission in Relation to Clinical Variables and PsychosocialFactors." @default.
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