title: Bipolar patients' quality of life in mixed states: a preliminary qualitative study.
abstract: BACKGROUND
  Approximately 20% of patients with bipolar disorder experience mixed states. Mixed states are associated with more comorbidity, poorer treatment response and prognosis, increased relapse rate, and decreased functioning. This study aimed to produce in-depth knowledge about bipolar patients' quality of life (QoL) and functioning related to mixed states.
  
  
  METHODS
  This study used qualitative research methods. A semi-structured interview guide based on a literature study was applied in interviews with 6 remitted bipolar I patients having experienced mixed states. A medical anthropological approach was applied to analyse the data.
  
  
  RESULTS
  Participants described mixed states as worse than other bipolar disorder states and their residual symptoms were prolonged. Mixed states affected the functioning of patients in key life domains such as self-esteem, family, love and social life, physical well-being, and working capability.
  
  
  CONCLUSIONS
  Mixed states may severely affect the QoL and functioning of bipolar patients. Our results indicate that improving these should be a main goal of patient treatment. With an aim of adequately identifying and treating mixed states, our findings highlight the need for knowledge about this particularly severe expression of bipolar disorder. These results should be confirmed in a larger sample of patients with varying socioeconomic status.
authors.affiliation: AnthroConsult, Aarhus, Denmark.
authors.forename: Gitte
authors.initials: G
authors.lastname: Lee Mortensen
authors.forename: Maj
authors.initials: M
authors.lastname: Vinberg
authors.forename: Steen
authors.initials: S
authors.lastname: Lee Mortensen
authors.forename: Martin
authors.initials: M
authors.lastname: Balslev Jørgensen
authors.forename: Jonas
authors.initials: J
authors.lastname: Eberhard
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000523:psychology*; D003071:Cognition; D015897:Comorbidity; D004522:Educational Status; D004644:Emotions; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D011788:Quality of Life; D012008:Recurrence; D012649:Self Concept; D012919:Social Behavior; D057545:Social Stigma; D018454:Spouses / Q000523:psychology; D013850:Thinking; D014937:Work