Quality of life in patients with bipolar 1 disorder: is it related to disorder outcome?

Bipolar 1 disorder [BID] and its treatments have shown to be associated with deep impacts on patients' subjective feelings and quality of life [QOL]. There are also some comments about impact of these feelings on course and outcome of patients with BID. This study was aimed to evaluate quality of life in patients with BID and to assess its relationship with course of disorder. Fifty patients with BID were recruited based on the Structured Clinical Interview for DSM-IV Axis I Disorders [SCID-I] from May 2008 and followed for 12 months. Quality of life and mood disorder recurrence were assessed through World Health Organization Quality of Life and SCID-I tools respectively at baseline and after 6 and 12 months. Repeated j measures analysis and logistic regression were used to analyze the independent effect of QOL and demographic factors on BID recurrence. Fifty patients [66% male; 48% never married; 48% in primary school level] with mean +/- SE age and age of BID onset 33.8 +/- 1.5 and 26.6 +/- 1.1 years were studied. They had 3.4 +/- 0.6 episodes already. Twenty eight percent suffered from recurrences during the follow-up. The QOL scores at baseline, after 6 and 12 months were 70 +/- 1.8, 69.6 +/- 1.1 and 73 +/- 1.3 respectively. There were no significant change in QOL and its sub-domains during the follow-up [P=0.37]. QOL showed no independent relationship with BID recurrences [P>0.1]. No change in the QOL during the follow-up could denote lack of effectiveness of routine interventions on this factor. Also, short-term follow-up might be concerned as the f possible reason. Of prime importance is to consider quality of life independently in treating patients with bipolar disorder

Reliability and validity of the bipolar depression rating scale on an Iranian sample

The Bipolar Depression Rating Scale is an instrument to measure depression severity in patients diagnosed with bipolar disorder. This study has reevaluated the psychometric values of the Bipolar Depression Rating Scale through assessing an Iranian sample of patients with bipolar depression. A total of 60 patients [36 males and 24 females] with bipolar depression referred to four medical centers in Tehran, Iran were interviewed with the Structured Clinical Interview for DSM-IV axis I Disorders, Young Mania Rating Scale, center for Epidemiological Studies Depression Scale, and the Bipolar Depression Rating Scale. Internal consistency and inter-rater reliability of the Bipolar Depression Rating Scale, and Pearson's correlation coefficient between the Bipolar Depression Rating Scale and Young Mania Rating Scale/Center for Epidemiological Studies Depression Scale were calculated. The Cronbach's alpha coefficient was 0.81. The Pearson's correlation coefficients of the Bipolar Depression Rating Scale with the Center for Epidemiological Studies Depression Scale and Young Mania Rating Scale were 0.73 and-0.82, respectively. The correlation coefficients between the two raters for the total score of the Bipolar Depression Rating Scale according to the Pearson's correlation and intraclass correlation tests were 0.83 and 0.89, respectively. The Bipolar Depression Rating Scale is a reliable and valid instrument to use in studies on Iranian clinical patients with bipolar depression

specific pattern of obsessive-compulsive symptoms in patients with bipolar disorder

Some preliminary findings have suggested that patients with bipolar disorder show a disparate pattern of obsessive-compulsive [OC] symptoms. This study aimed to reevaluate this subject on a different sample within a different cultural background. The present cross-sectional study was carried out in a clinical non-experimental setting on 78 obsessive-compulsive disorder [OCD] patients; 39 with and 39 without bipolar disorder [BD]. Subjects underwent a Structured Clinical Diagnostic Interview for DSM-IV [SCID-I] as well as the Yale-Brown Obsessive-Compulsive Rating Scale [Y-BOCS]. The diagnoses in the non-bipolar group were mostly major depressive disorder [38%] and dysthymic disorder [38%]. The mean age of the bipolar group was significantly lower than that of the non-bipolars [P<0.05]. The mean score of the Y-BOCS was not significantly different between the two groups. The mean estimated number of obsessive themes - but not compulsive ones - in the bipolar group was significantly higher than that of the non-bipolars [P<0.0001]. The aggressive [P<0.01], sexual [P<0.0001] and religious [P<0.05] obsessions were significantly more prevalent, and the contamination obsession [P<0.05] was significantly less prevalent in the bipolar group. Also, in the bipolar group the miscellaneous compulsions [P<0.01] were significantly more prevalent, and the washing compulsion [P<0.001] was significantly less prevalent. The content of OC symptoms which is not traditionally considered a helpful factor for diagnosing a psychiatric disorder might be able to lead the clinician to the diagnosis of bipolarity in a depressed patient with OCD

Non-compliance after first episode of manic or mixed mood state: a 17-month follow-up

This study aimed to evaluate the non-compliance rate in patients with bipolar I disorder. The patients admitted to Iran Psychiatric Hospital who were diagnosed as a case of the first episode mania of bipolar I disorder [DSM-IV-TR] by 2 psychiatrists followed by one of them in a longitudinal, prospective and naturalistic study. In the follow-up early non-compliance/irregular drugs use, drug discontinuation and good compliance [GC] in the patients were registered in addition to the recurrences of mood episodes. The term poor compliance [PC] was used for early non-compliance/irregular drugs use and drug discontinuation. The patients were 11 males and 11 females aged 19.6 to 59 [28.4 +/- 10.4]. The study lasted 32.5 months and the subjects were followed between 8 to 24 months [17 +/- 5.3]. Poor compliance [PC] was observed in 8 subjects [38.1%] with male to female ratio of 1.7. Six subjects in PC group [75%] and 3 subjects [23.1%] in GC group had a recurrence of mood episode. Eight subjects with poor compliance included 3 with non-compliance/irregular use and 5 with drug discontinuation. The poor compliance rate in BID cases admitted to this center is close to the previous studies. Repitition of the study with a larger sample size and in multi-center setting is proposed

[Reliability of the Persian translation of the composite international diagnostic interview [CIDI] for diagnosing schizophrenia and bipolar disorder]

This study aimed to assess the reliability of the Persian version of the Composite International Diagnostic Interview [CIDI] for a lifetime diagnosis of schizophrenia and bipolar disorder according to DSM-IV and lCD-10. This project was conducted at three stages of translation of the instrument, reliability assessment and validation, and feasibility and diagnostic reliability assessments for bipolar disorder and schizophrenia using a test-retest methodology. Trained interviewers administered the instrument twice [at 3-7 days' interval] to 100 clients at four university centers [complete CIDI on 65 persons and psychosis/mania module on 35 persons]. Test-retest reliability of CIDI for bipolar disorder was moderate in DSM-IV diagnostic system and poor in ICD-10. Test-retest reliability of CIDI for schizophrenia was poor in both diagnostic systems. The results showed that the diagnostic reliability was good only for bipolar disorder in DSM-IV, otherwise it was not acceptable. However, since the samples were selected from the clinical population, the results cannot be generalized to the normal population. According to the results, adaptation of the key questions to the Persian culture must be considered

[Reliability and feasibility of the Persian version of the structured diagnostic interview for DSM-IV [SCID]]

In this study the Structured Diagnostic Interview for DSM-IV axis I disorders [SCIDI] was translated into Persian using a cross-cultural methodology, and its reliability and feasibility was tested in a multi-center study. The study had two phases: a] translation of the instrument and assessing the cross-cultural equivalence, including forward and backward translation, and face validity of the translated version in regard with cross-cultural characteristics; b] reliability and feasibility assessment of the Persian translation on an Iranian clinical population. This is part of a larger study on validation of the SCID on 299 subjects admitted to outpatient and inpatient services of thee psychiatric centers [Roozbeh Hospital, Imam Hossein Hospital and Iran Hospital] in Tehran, Iran. For test-retest reliability assessment, two SCID interviews [3 to 7 days apart] were administered to 104 subjects and the level of diagnostic agreement was assessd. Feasibility for interviewees [n=299] and interviewers was tested by questionnaires considering the length of interview, its being boring/tiring, comprehensibility and acceptance of the questions, and difficulty of administration. Diagnostic agreement of SCID test and retest were fair to good for most diagnostic categories [kappas over 0.6]. Overall weighted kappa equaled 0.52 for current diagnoses and 0.55 for lifetime diagnoses. Most interviewees and interviewers reported the administration of the Persian SCID as feasible. Acceptable reliability of diagnoses made by the Persian translation of SCID, and its feasibility suggest it as a useful diagnostic instrument in clinical, research, and educational settings