UBC Theses and Dissertations
Quality of life, functional outcomes, and depression : 3 years following the onset of bipolar disorder. Dhanoa, Tajwindera
Background: Quality of Life (QoL) and functional outcomes appear to be markers of mental health but little is known about their trajectory in the early stages of Bipolar Disorder Type I (BD I). Early phase depression appears to have a significant influence on such outcomes. This study observed the trajectory of QoL and functional outcomes and examined if (a) number of prodromal depressive episodes (prior to the first episode of mania) (b) the total number of episodes of depression experienced by 3 years, and (c) severity of ongoing depressive symptomatology, impacted QoL and functioning, across the first 3 years following the first episode of mania in a cohort of individuals with BD I. Methods: 40 individuals diagnosed with BD I and recovering from their first episode of mania were recruited from an overarching clinical program based in a hospital setting. Participants completed assessments for QoL (the Quality of Life Enjoyment and Satisfaction Questionnaire), functionality (the Multidimensional Scale of Independent Functioning), and depressive symptomology (Hamilton Depression Rating Scale) annually from baseline to year 3. Any history of prodromal and recurrent depressive episodes was also recorded. Results: QoL and functionality were observed to improve between baseline and year 1, and then stabilize up to year 3. OLS regression was utilized to assess the predictors of QoL and functional outcomes. Higher severity of depressive symptomology at baseline and year 3 were found to be predictive of lower QoL at 3 years following the onset of illness. No depression variables were significantly related to QoL or functionality difference scores between year 3 and baseline. Conclusion: This is the first longitudinal study to (a) examine the trajectory of QoL and functionality in the first 3 years of illness in a First Episode Mania (FEM) sample of individuals with BD I and (b) examine the relationship of multiple depression variables to QoL at year 3 as well as change in QoL and functionality from baseline to year 3. The findings support the need for treatment to focus on the management of depressive symptomology in the early stages of BD I, which in turn may enhance QoL.
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