Quality of life in bipolar disorder

When treating a mental illness, the goal is typically to eliminate all or most symptoms, allowing the individual to resume normal daily functioning and to feel better.

Bipolar disorder is no exception. In treatment, the goal is to stabilize mood and stop the person from shifting between the dramatic and dangerous highs of mania and the lows of depression.

A combination of medication and therapy can often achieve this goal and treatment is generally considered successful once mood symptoms are gone.

A recent study measuring quality of life in bipolar patients has now identified another area to examine when treating this difficult condition, cognitive function.

In recent years it has become apparent that more than mood is affected by bipolar disorder. Patients also seem to experience cognitive impairments particularly in the areas of attention, processing speed, memory, executive function and verbal abstraction.

The current study examined 55 bipolar patients whose mood symptoms were either in full remission or at least dramatically improved with conventional treatment. An additional 50 healthy volunteers were also involved in the study as a control group.

Study subjects were given a variety of tests and questionnaires to determine their perceived quality of life. Individuals with bipolar disorder scored lower in all quality of life domains than the control group and researchers learned mood symptoms were not the only reason.

Persistent cognitive impairments also significantly affected perceived quality of life among bipolar patients. Even though mood symptoms were either controlled or non-existent, bipolar patients did worse than healthy volunteers on many cognitive tests and this impairment was associated with lower quality of life.

Although this study was limited in scope, it is one of the first to highlight the impact of cognitive impairment on individuals with bipolar disorder.

It also emphasizes the question of whether or not current treatments alleviate these cognitive impairments. Right now treatments focus primarily on stabilizing mood and we are unsure to what extent cognitive deficits improve as a result.

Further research into this new area is warranted. I believe cognitive impairments are under recognized in bipolar disorder and very important. Not only do persisting impairments affect quality of life even for individuals considered in full remission, but they likely cause significant disability in work and other settings.

Ideally, treatments of the future would alleviate all symptoms caused by the disorder so that patients could function at the same level as their non-bipolar peers. This could involve newer medications or more targeted therapy than what is currently available. Only more research will answer these questions.


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