Louisa G Sylvia1, Dustin J Rabideau2, Andrew A Nierenberg2, Charles L Bowden3, Edward S Friedman4, Dan V Iosifescu5, Michael E Thase6, Terence Ketter7, Elizabeth A Greiter2, Joseph R Calabrese8, Andrew C Leon9, Michael J Ostacher10, Noreen Reilly-Harrington2. 1. Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States. Electronic address: lsylvia2@partners.org. 2. Massachusetts General Hospital, 50 Staniford Street, Suite 580, Boston, MA 02114, United States. 3. University of Texas Health Science Center, San Antonio, United States. 4. University of Pittsburgh School of Medicine, United States. 5. Mount Sinai School of Medicine, United States. 6. University of Pennsylvania School of Medicine, United States. 7. Stanford University, United States. 8. Case Western Reserve University School of Medicine, United States. 9. Weill Cornell Medical College, United States. 10. VA Palo Alto Health Care System and Stanford University, United States.
Abstract
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. 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.
RCT Entities:
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. 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.
Authors: A C Leon; D A Solomon; T I Mueller; J Endicott; M Posternak; L L Judd; P J Schettler; H S Akiskal; M B Keller Journal: J Nerv Ment Dis Date: 2000-12 Impact factor: 2.254
Authors: Gabriele S Leverich; Lori L Altshuler; Mark A Frye; Trisha Suppes; Paul E Keck; Susan L McElroy; Kirk D Denicoff; Gabriela Obrocea; Willem A Nolen; Ralph Kupka; Jörg Walden; Heinz Grunze; Sara Perez; David A Luckenbaugh; Robert M Post Journal: J Clin Psychiatry Date: 2003-05 Impact factor: 4.384