Psychosocial Factors and Comorbidity Associated With Recovery in Bipolar Disorder - Psychosocial Factors and Comorbidity Associated With Recovery in Bipolar Disorder - Open Access Pub

Bipolar disorder (BD) is a chronic psychiatric illness impacting patient functioning and quality of life. Medication produces improvement in many patients and remission in some, but there is minimal understanding about why some patients improve and others do not. Our goal was to identify demographic, psychosocial and comorbid variables associated with outcomes in BD. Charts of 121 outpatients treated with medication and supportive psychotherapy were reviewed. Forty four percent attained euthymia for 12 months while 56% did not. Poorer outcome was associated with economic stress, missed appointments, life stress, and presence of pain (p < 0.05). Those employed were more likely to improve (p < 0.02). Patients with BP-II reported more frequent life stressors, headache and use of alcohol (p <0.05) and were less likely to achieve euthymia than BP-I. Gender, education, and co-morbid medical illness did not affect results. Our findings suggest that poorer outcome is related to psychosocial factors. Increased attention to these variables may increase providers’ ability to manage challenging patients with BD. DOI10.14302/issn.2476-1710.jdt-15-762 Bipolar disorder (BD) is a chronic, severe mental illness, with a lifetime prevalence between 1.4 and 6%; patients experience profound effects on daily functioning and quality of life 1,2. Although pharmacologic treatment guidelines are available and many patients respond well to pharmacotherapy, recommendations are inconsistent 3,4. Our previous study reported that a combination of an atypical antipsychotic, a mood stabilizer and an antidepressant was associated with 12 months of recovery in a sample of BD patients. Forty three percent of the sample achieved recovery while the remainder did not 5. Patients with Type II BD hav a higher lifetime prevalence of anxiety disorders compared to BD I 6. A more chronic course of illness was also found in Type II suggesting that the disability associated with BP-II is greater than previously acknowledged 7. Similarly, it was noted by some authors that patients with BD II spent a higher proportion of time with depressive symptoms which lowered functionality, but others saw no differences between patients with either type in the length of time spent with depressive symptoms 8, 9. Since between 30 to 60% of patients do not attain full functioning following treatment, exploration of additional factors correlated with persistent impairment in BD is warranted 10. Research investigating psychosocial factors and comorbidity, such as the number of previous episodes, psychotic symptoms,