Quality of life in patients with bipolar I depression: data from 920 patients

To determine the impact of acute depression on quality of life (QOL) in patients with bipolar I disorder and to compare these results with published data on QOL in patients with unipolar depression.

Quality of life was assessed using the SF-36 in bipolar patients (n = 958) who had recently experienced an episode of acute bipolar depression and participated in a large randomized, double-blind, safety and efficacy trial. Seven studies that included SF-36 data from patients with unipolar depression were identified in the published literature and descriptive comparisons of SF-36 scores were made between the unipolar depression trials and this bipolar depression trial.

There were 920 patients who completed the SF-36. Mean transformed scores, which could range from 0 to 100, were very low in bipolar depressed patients for the role-physical (36.7), vitality (22.4), social functioning (29.9), role-emotion (11.4), and mental health (31.0) subscales. Mean SF-36 scores for all subscales were significantly and inversely correlated (p < 0.0001) with the HAM-D indicating that patients with milder depressive symptoms had better QOL. Further, the mean SF-36 scores for the bipolar sample were consistently lower compared with published data on QOL in unipolar depression on four of the eight subscales: general health; social functioning; role-physical, and role-emotional.

While both unipolar and bipolar depression have serious detrimental effects on patient QOL, our results suggest that some aspects of QOL may be worse in bipolar depression.