Health values of patients with bipolar disorder

Despite a growing number of studies of patients' health values (utilities), little is known about health values of patients with mental illness, particularly bipolar (manic-depressive) disorder.

We administered a computerized rating scale, time tradeoff, and standard gamble to 53 patients. Patients were asked to rate or value their current state of health overall and then their current mental health. In addition, we administered the SF-36; Inventory of Depressive Symptoms (IDS-C); Positive and Negative Syndrome Scale (PANSS); Young Mania Rating Scale (YMRS); and Global Assessment of Functioning Scale.

The patients' median (25th, 75th percentile) age was 43 (37, 50); 62% were female. Mean (+/- SD) health ratings for current overall health were 68.0 (+/- 20.3) vs. 61.0 (+/- 25.7) for current mental health (p-value for difference = 0.02). On the time tradeoff, scores for current overall health averaged 0.71 (+/- 0.37) vs. 0.61 (+/- 0.39) for current mental health (p = 0.02); on the standard gamble, mean scores were 0.77 (+/- 0.32) for current overall health vs. 0.70 (+/- 0.35) for current mental health (p = 0.11). In univariate analyses, rating scale, time-tradeoff, and standard gamble scores for both current overall health and for current mental health were correlated with the SF-36 and all psychiatric scale (magnitude of r = 0.22-0.76) except the YMRS (magnitude of r < or = 0.13). In multivariable analyses, health values for current overall health were related to factors different from those that were related to health values for current mental health (R2 = 0.38-0.65), and none of the health value measures was related to the YMRS.

Health values of patients with bipolar disorder are higher for their current health overall than for their current state of mental health. Health values are related to certain health status attributes and to level of depression but perhaps not to level of mania.