Psychiatry Research EG

Good quality of life (QoL) encompasses more than just good health. At a basic level, it can represent the sum of an individual’s physical, emotional, social, occupational, and spiritual well-being, the study of which is complicated by the fact that there is no consensus as to what constitutes QoL. The WHO has described QoL as ‘Individuals’ perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns’ [1]. Recently, psychiatric outcomes research has paid increasing attention to the concept of QoL [2]. The QoL of patients with bipolar disorder (BD) has been receiving increasing attention recently, as other psychiatric conditions have received in the past [3]. According to a worldwide study of burden of disease [4], BD is, among the psychiatric disorders, the second cause of disability, only after depression and before schizophrenia. BD is characterized by intermittent episodes of depression and mania that can considerably disrupt the lives of patients and families [5,6]. In contrast to other psychiatric disorders, only three BD studies [7–9] have compared scores on a QoL measure with a general population sample; using the Medical Outcomes Survey 36-items Short-Form Health Survey (SF-36) [10,11], they found lower scores on measures related to mental health [7–9], and two of them [8,9] found lower scores on measures related to physical health. The impact of BD on QoL appears to be of less magnitude than the impact of schizophrenia [12], and is similar to or worse than the impact of chronic diseases such as multiple sclerosis, chronic renal disease, or rheumatoid arthritis [7,13–15]. Self-report of QoL in bipolar patients is likely to be influenced by ‘mood bias’ or cognitive distortions of selfconcept and functioning [16,17]. Study of patients with BD who are in remission or clinically euthymic bipolar,patients can reduce this ‘mood bias’. Yet, only a few studies have reported on QoL in bipolar patients in remission [7,13,14,18–22].