Journal of Affective Disorders
Volume 86, Issue 1 , Pages 47-60, May 2005

Medical comorbidity and health-related quality of life in bipolar disorder across the adult age span

  • Howard H. Fenn

      Affiliations

    • Adjunct Clinical Associate Professor of Psychiatry Stanford University; Veterans Affairs Palo Alto Health Care System-Building 348-Menlo Park Division, 795 Willow Road, Menlo Park, CA 94025-6328 94025, United States
    • Corresponding Author InformationCorresponding author. Tel.: +1 650 493 5000x26141; fax: +1 650 614 9842.
    • ,
  • Mark S. Bauer

      Affiliations

    • Providence VAMC and Brown University, United States
    • ,
  • Lori Alshuler

      Affiliations

    • West Los Angeles (CA) and UCLA, United States
    • ,
  • Denise R. Evans

      Affiliations

    • Augusta VAMC and Georgia Medical College, United States
    • ,
  • William O. Williford

      Affiliations

    • Perry Point Cooperative Studies Coordinating Center, Perry Point, MD, United States
    • University of Maryland, College Park, MD, United States
    • ,
  • Amy M. Kilbourne

      Affiliations

    • Pittsburgh VAMC and University of Pittsburgh, United States
    • ,
  • Thomas P. Beresford

      Affiliations

    • Denver VAMC and University of Colorado, United States
    • Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston, MA, United States
    • ,
  • Gail Kirk

      Affiliations

    • Perry Point Cooperative Studies Coordinating Center, Perry Point, MD, United States
    • ,
  • Margaret Stedman

      Affiliations

    • Denver VAMC and University of Colorado, United States
    • Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston, MA, United States
    • ,
  • Louis Fiore

      Affiliations

    • Denver VAMC and University of Colorado, United States
    • Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), Boston, MA, United States
    • ,
  • for the VA Cooperative Study #430 Team

Received 26 May 2004; accepted 9 December 2004.

Abstract 

Background

Little is known about medical comorbidity or health-related quality of life (HRQOL) in bipolar disorder across the adult age span, especially in public sector patients.

Methods

We obtained cross-sectional demographic, clinical, and functional ratings for 330 veterans hospitalized for bipolar disorder with Mini-Mental State score ≥27 and without active alcohol/substance intoxication or withdrawal, who had had at least 2 prior psychiatric admissions in the last 5 years. Structured medical record review identified current/lifetime comorbid medical conditions. SF-36 Physical (PCS) and Mental (MCS) Component Scores, measured physical and mental HRQOL. Univariate and multivariate analyses addressed main hypotheses that physical and mental function decrease with age with decrements due to increasing medical comorbidity.

Results

PCS decreased (worsened) with age; number of current comorbid medical diagnoses, but not age, explained the decline. Older individuals had higher (better) MCS, even without controlling for medical comorbidity. Multivariate analysis indicated association of MCS with age, current depressed/mixed episode, number of past-year depressive episodes, and current anxiety disorder, but not with medical comorbidity, number of past-year manic episodes, current substance disorder or lifetime comorbidities.

Limitations

This cross-sectional design studied a predominantly male hospitalized sample who qualified for and consented to subsequent randomized treatment.

Conclusions

Medical comorbidity is associated with lower (worse) physical HRQOL, independent of age. Surprisingly, younger rather than older subjects reported lower mental HRQOL. This appears due in part to more complex psychiatric presentations, and several mechanisms are discussed. Both results suggest that age-specific assessment and treatment may enhance HRQOL outcome.

Keywords: Bipolar disorder, Medical comorbidity, Health-related quality of life, Anxiety disorders, Substance disorders

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PII: S0165-0327(04)00442-2

doi:10.1016/j.jad.2004.12.006

Refers to corrigendum:

  • Corrigendum to “Medical comorbidity and health-related quality of life in bipolar disorder across the adult age span” [J. Affect. Disord. 86 (2005) 47–60]

    Howard H. Fenn, Mark S. Bauer, Lori Altshuler, Denise R. Evans, William O. Williford, Amy M. Kilbourne, Thomas P. Beresford, Gail Kirk, Margaret Stedman, Louis Fiore, for the VA Cooperative Study #430 Team
    Journal of Affective Disorders February 2006 (Vol. 90, Issue 2, Page 275)

Journal of Affective Disorders
Volume 86, Issue 1 , Pages 47-60, May 2005

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