title: Trajectory and predictors of quality of life in first episode psychotic mania.
abstract: BACKGROUND
  Little is known about the trajectory of quality of life (QoL) following a first episode of psychotic mania in bipolar disorder (BD). This 18-month longitudinal study investigated the trajectory of QoL, and the influence of premorbid adjustment and symptoms on 18-month QoL in a cohort of young people experiencing a first episode of psychotic mania.
  
  
  METHODS
  As part of an overarching clinical trial, at baseline, sixty participants presenting with a first episode of psychotic mania (BD Type 1 - DSM-IV) completed symptomatic and functional assessments in addition to the Premorbid Adjustment Scale - General Subscale. Symptom measures were repeated at 18-month follow up. QoL was rated using the Quality of Life Scale (QLS) at designated time points.
  
  
  RESULTS
  Mean QLS scores at initial measurement (8 weeks) were 61% of the maximum possible score, increasing significantly to 70% at 12 months, and 71.2% at 18-month follow-up. Premorbid adjustment and 18-month depressive symptoms were significantly associated with QoL at 18-month follow-up.
  
  
  CONCLUSIONS
  Study limitations include the small sample size, inclusion of participants with psychotic mania only, use of measures originally designed for use with schizophrenia spectrum disorders, and lack of premorbid or baseline measurement of QoL.
  
  
  CONCLUSIONS
  Results suggest that QoL can be maintained early in BD, and reinforce the importance of assertively treating depressive symptoms throughout the course of this disorder. The emergence of a link between premorbid adjustment and poorer QoL in this cohort highlights the importance of assessing facets of adjustment when planning psychological interventions.
authors.affiliation: Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Oldis
authors.affiliation: Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Australia. Electronic address: gwm@swin.edu.au.
authors.forename: Greg
authors.initials: G
authors.lastname: Murray
authors.affiliation: Orygen Youth Health - Clinical Program, Parkville, Australia.
authors.forename: Craig A
authors.initials: CA
authors.lastname: Macneil
authors.affiliation: Orygen Youth Health - Clinical Program, Parkville, Australia.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Hasty
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
authors.forename: Rothanthi
authors.initials: R
authors.lastname: Daglas
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia; IMPACT Strategic Research Centre, Deakin University, School of Medicine, Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Parkville, Australia; Department of Psychiatry, University of Melbourne, Parkville, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Berk
authors.affiliation: Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, 1008 Prilly, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Conus
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.
authors.forename: Sue M
authors.initials: SM
authors.lastname: Cotton
mesh_terms: D000293:Adolescent; D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000523:psychology*; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D004651:Employment; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012565:Schizophrenic Psychology; D012919:Social Behavior; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Bipolar disorder; First episode; Mania; Psychosis; Quality of Life