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Quality of life and resource use in patients with bipolar disorder in Europe and the USA
S110
Abstracts / Journal of Affective Disorders 107 (2008) S53–S122
Objectives: We evaluated the frequency of bipolar disorder among patients presenting with depressive episodes, but who have never been diagnosed with bipolar disorder in Korean subjects and tried to identify which clinical variables were helpful in detecting bipolar disorder. In addition, we assessed the psychometric properties of the Mood Disorder Questionnaire (MDQ) to distinguish bipolar disorder from unipolar disorder in these subjects and tested whether modifications of the MDQ scoring might improve its performance. Methods: We evaluated consecutive patients who satisfied the inclusion criteria of a current depressive episode, plus at least one previous depressive episode. None of the subjects were previously diagnosed with bipolar disorder. Results: Fifty-nine patients (53.2%) were classified as bipolar. Brief depressive episodes (in 57.6% of bipolar patients but in only 30.8% of unipolar subjects, P =0.007), early age of onset (57.6% vs. 25.0%, P = 0.001), and mood lability (57.6% vs. 25.0%, P = 0.001) were found to be significantly more prevalent in patients with bipolar than unipolars. We found that a modified scoring of the MDQ (ignoring question on functional impairment and co-occurrence of symptoms) yielded a sensitivity of 0.68 and a specificity of 0.63 for bipolar diagnosis, while the figures were 0.29 and 0.77 respectively with the standard MDQ scoring. Conclusions: The results of this study clearly indicate a high frequency of bipolar disorders in depressive patients who have never been diagnosed with bipolar disorders. When the scoring was modified, the MDQ could be useful as a screening tool for detecting bipolar disorder in these subjects. Keywords: Bipolar disorder, Depressive episode, MDQ doi:10.1016/j.jad.2007.12.118
[P2.27] Quality of life and resource use in patients with bipolar disorder in Europe and the USA O. Leeuwenkamp*,a, R. Morlockb, G. Milliganc, R. Perryc
Methods: Data were obtained from the Adelphi Bipolar Disease Specific Programme. In this survey, physicians completed a questionnaire concerning their patients' clinical status and treatment. Patients completed the EuroQol EQ-5D, which assesses QOL, with responses used to generate EQ-5D utility scores. Each patient rated their health state using the EQ-5D visual analog scale (VAS) and reported resource use during the preceding 12 months. Results: Data were collected from patients in the USA (n = 506), France (n = 270), Germany (n = 329), Italy (n = 259), Spain (n = 177), and the UK (n = 221). Reasons for physician visits were maintenance of treatment (50%) and depressed (20%), mixed (10%), manic (10%), or hypomanic (9%) health states. Across all countries, mean (± SD) EQ-5D utility scores (76.8 ± 24.8) were higher than EQ-5D VAS scores (64.0 ± 20.6). Highest EQ-5D utility and VAS scores were reported by German patients (82.8 ± 20.3 and 67.1 ± 22.4, respectively); lowest EQ-5D utility scores were reported by French patients (70.1 ± 28.6), and lowest VAS scores were reported by Italian patients (59.1 ± 18.5). EQ-5D utility scores were significantly lower in patients reporting a depressed health state (64.6 ± 28.7) compared with manic (80.6 ± 25.6; P b 0.001) or hypomanic (82.6 ± 22.3; P b 0.0001) health states but did not differ significantly from mixed health state (68.8 ± 27.6). Patients in the lowest EQ-5D quartile had the highest mean number of drugs prescribed (2.48 ± 1.13 vs 1.82 ± 0.85 for patients in the highest quartile; P b 0.001) and a tendency toward more frequent hospital visits. Discussion: Patient-reported QOL varied substantially according to phase of illness. Depressed health state was associated with the lowest QOL scores, which in turn were associated with the highest number of prescribed drugs and hospital visits. Successful treatment of the depressed state in bipolar disorder may improve QOL and reduce resource use. Keywords: Quality of life, Resource use, Bipolar disorder doi:10.1016/j.jad.2007.12.119
a
NV Organon, The Netherlands Employed at Pfizer Inc, New York, NY, at the time of the research was conducted, USA c Adelphi Group Products, UK b
[P2.28] Does history of manic switch predict time to remission and duration until next episode? K. Atinbas*, E. Timucin
Introduction: Our objective was to provide information on self-reported quality of life (QOL) and resource use in patients with bipolar disorder.
Bakirkoy State Teaching and Research Hospital for Neuropsychiatry, Turkey
Abstracts / Journal of Affective Disorders 107 (2008) S53–S122
Objectives: We evaluated the frequency of bipolar disorder among patients presenting with depressive episodes, but who have never been diagnosed with bipolar disorder in Korean subjects and tried to identify which clinical variables were helpful in detecting bipolar disorder. In addition, we assessed the psychometric properties of the Mood Disorder Questionnaire (MDQ) to distinguish bipolar disorder from unipolar disorder in these subjects and tested whether modifications of the MDQ scoring might improve its performance. Methods: We evaluated consecutive patients who satisfied the inclusion criteria of a current depressive episode, plus at least one previous depressive episode. None of the subjects were previously diagnosed with bipolar disorder. Results: Fifty-nine patients (53.2%) were classified as bipolar. Brief depressive episodes (in 57.6% of bipolar patients but in only 30.8% of unipolar subjects, P =0.007), early age of onset (57.6% vs. 25.0%, P = 0.001), and mood lability (57.6% vs. 25.0%, P = 0.001) were found to be significantly more prevalent in patients with bipolar than unipolars. We found that a modified scoring of the MDQ (ignoring question on functional impairment and co-occurrence of symptoms) yielded a sensitivity of 0.68 and a specificity of 0.63 for bipolar diagnosis, while the figures were 0.29 and 0.77 respectively with the standard MDQ scoring. Conclusions: The results of this study clearly indicate a high frequency of bipolar disorders in depressive patients who have never been diagnosed with bipolar disorders. When the scoring was modified, the MDQ could be useful as a screening tool for detecting bipolar disorder in these subjects. Keywords: Bipolar disorder, Depressive episode, MDQ doi:10.1016/j.jad.2007.12.118
[P2.27] Quality of life and resource use in patients with bipolar disorder in Europe and the USA O. Leeuwenkamp*,a, R. Morlockb, G. Milliganc, R. Perryc
Methods: Data were obtained from the Adelphi Bipolar Disease Specific Programme. In this survey, physicians completed a questionnaire concerning their patients' clinical status and treatment. Patients completed the EuroQol EQ-5D, which assesses QOL, with responses used to generate EQ-5D utility scores. Each patient rated their health state using the EQ-5D visual analog scale (VAS) and reported resource use during the preceding 12 months. Results: Data were collected from patients in the USA (n = 506), France (n = 270), Germany (n = 329), Italy (n = 259), Spain (n = 177), and the UK (n = 221). Reasons for physician visits were maintenance of treatment (50%) and depressed (20%), mixed (10%), manic (10%), or hypomanic (9%) health states. Across all countries, mean (± SD) EQ-5D utility scores (76.8 ± 24.8) were higher than EQ-5D VAS scores (64.0 ± 20.6). Highest EQ-5D utility and VAS scores were reported by German patients (82.8 ± 20.3 and 67.1 ± 22.4, respectively); lowest EQ-5D utility scores were reported by French patients (70.1 ± 28.6), and lowest VAS scores were reported by Italian patients (59.1 ± 18.5). EQ-5D utility scores were significantly lower in patients reporting a depressed health state (64.6 ± 28.7) compared with manic (80.6 ± 25.6; P b 0.001) or hypomanic (82.6 ± 22.3; P b 0.0001) health states but did not differ significantly from mixed health state (68.8 ± 27.6). Patients in the lowest EQ-5D quartile had the highest mean number of drugs prescribed (2.48 ± 1.13 vs 1.82 ± 0.85 for patients in the highest quartile; P b 0.001) and a tendency toward more frequent hospital visits. Discussion: Patient-reported QOL varied substantially according to phase of illness. Depressed health state was associated with the lowest QOL scores, which in turn were associated with the highest number of prescribed drugs and hospital visits. Successful treatment of the depressed state in bipolar disorder may improve QOL and reduce resource use. Keywords: Quality of life, Resource use, Bipolar disorder doi:10.1016/j.jad.2007.12.119
a
NV Organon, The Netherlands Employed at Pfizer Inc, New York, NY, at the time of the research was conducted, USA c Adelphi Group Products, UK b
[P2.28] Does history of manic switch predict time to remission and duration until next episode? K. Atinbas*, E. Timucin
Introduction: Our objective was to provide information on self-reported quality of life (QOL) and resource use in patients with bipolar disorder.
Bakirkoy State Teaching and Research Hospital for Neuropsychiatry, Turkey