title: Health-related quality of life and functioning in remitted bipolar I outpatients.
abstract: The aim of this study was to characterize the health-related quality of life (HR-QOL) and functioning in 90 bipolar I remitted outpatients. According to Diagnostic and Statistical Manual of Mental Disorders IV remission specifiers, patients were categorized into 4 groups: group 1, fully remitted; group 2, less than 2 months remitted; group 3, with persisting manic symptoms; group 4, with persisting depressive symptoms. The severity of psychopathology was evaluated by using the Bech-Rafaelsen Mania-Melancholia Scale. The HR-QOL, functioning, and insight were assessed via the medical outcomes study 36-item short form, the global assessment of functioning scale, and the scale to assess unawareness of mental disorder, respectively. Fully remitted patients reported the highest scores in almost all domains of medical outcomes study 36-item short form, and had significantly higher scores on physical functioning, general health, social functioning, and mental health compared to patients with persisting depressive symptoms. Furthermore, patients with persisting manic symptoms reported significantly higher scores on general health, vitality and mental health than the group with persisting depressive symptoms. In contrast, the global assessment of functioning scale score differed among the 4 groups, with fully remitted patients reporting higher, although not statistically significant, scores than the other groups. Our data suggest that the persistence of depressive or manic symptoms seem to affect self-report measures of HR-QOL. An affectively biased cognition may explain the gap between patient's perception of functioning and estimated functional adjustment, as assessed by clinicians.
authors.affiliation: Department of Psychiatry, Neurobiology, Pharmacology and Biotechnology, University of Pisa, 56127 Pisa, Italy. a.piccinni@med.unipi.it
authors.forename: Armando
authors.initials: A
authors.lastname: Piccinni
authors.forename: Mario
authors.initials: M
authors.lastname: Catena
authors.forename: Alessandro
authors.initials: A
authors.lastname: Del Debbio
authors.forename: Donatella
authors.initials: D
authors.lastname: Marazziti
authors.forename: Cristina
authors.initials: C
authors.lastname: Monje
authors.forename: Elisa
authors.initials: E
authors.lastname: Schiavi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Mariotti
authors.forename: Carolina
authors.initials: C
authors.lastname: Bianchi
authors.forename: Agnese
authors.initials: A
authors.lastname: Palla
authors.forename: Isabella
authors.initials: I
authors.lastname: Roncaglia
authors.forename: Marina
authors.initials: M
authors.lastname: Carlini
authors.forename: Stefano
authors.initials: S
authors.lastname: Pini
authors.forename: Liliana
authors.initials: L
authors.lastname: Dell'Osso
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000553:Ambulatory Care; D001294:Attitude to Health; D001364:Awareness; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000523:psychology; D015331:Cohort Studies; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data*; D011788:Quality of Life; D012720:Severity of Illness Index; D012917:Social Adjustment