TY - JOUR
T1 - The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder
AU - Sylvia, Louisa G.
AU - Rabideau, Dustin J.
AU - Nierenberg, Andrew A.
AU - Bowden, Charles L.
AU - Friedman, Edward S.
AU - Iosifescu, Dan V.
AU - Thase, Michael E.
AU - Ketter, Terence
AU - Greiter, Elizabeth A.
AU - Calabrese, Joseph R.
AU - Leon, Andrew C.
AU - Ostacher, Michael J.
AU - Reilly-Harrington, Noreen
N1 - Funding Information:
This study was funded by the National Institute of Mental Health , Contract ♯ NO1MH80001 .
Funding Information:
Dr. Friedman receives grant support from Novartis, St. Jude Medical, Medtronics, Repligen, Astra-Zeneca, Roche, and Takeda. He receives royalties from Springer.
Funding Information:
Dr. Sylvia was a shareholder in Concordant Rater Systems and serves as a consultant for United Biosource Corporation and Clintara. She receives royalties from New Harbinger and research funding from the National Institute of Mental Health and the American Foundation of Suicide Prevention.
Publisher Copyright:
©2014 Elsevier B.V. All rights reserved.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Conclusions Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder.Objectives The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium.Methods In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus "optimal personalized treatment (OPT)", or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning.Results Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over 6 months, patients in both treatment groups improved in quality of life and life functioning (p-Values<0.0001); without a statistically significant difference between the two treatment groups (p-Values>0.05). Within the lithium group, improvement in quality of life and functioning was not associated with concurrent lithium levels at week 12 or week 24 (p-Values>0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over 6 months.
AB - Conclusions Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder.Objectives The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium.Methods In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus "optimal personalized treatment (OPT)", or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning.Results Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over 6 months, patients in both treatment groups improved in quality of life and life functioning (p-Values<0.0001); without a statistically significant difference between the two treatment groups (p-Values>0.05). Within the lithium group, improvement in quality of life and functioning was not associated with concurrent lithium levels at week 12 or week 24 (p-Values>0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over 6 months.
KW - Bipolar disorder
KW - Life functioning
KW - Lithium
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=84908410290&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84908410290&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2014.08.019
DO - 10.1016/j.jad.2014.08.019
M3 - Article
C2 - 25194782
AN - SCOPUS:84908410290
VL - 169
SP - 144
EP - 148
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -