PittsburghV1, Main, Exploration, bibRecord, 004E19

The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder

Identifieur interne : 004E19 ( Main/Exploration ); précédent : 004E18; suivant : 004E20

The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder

Auteurs : Louisa G. Sylvia [États-Unis] ; Dustin J. Rabideau [États-Unis] ; Andrew A. Nierenberg [États-Unis] ; Charles L. Bowden [États-Unis] ; Edward S. Friedman [États-Unis] ; Dan V. Iosifescu [États-Unis] ; Michael E. Thase [États-Unis] ; Terence Ketter [États-Unis] ; Elizabeth A. Greiter [États-Unis] ; Joseph R. Calabrese [États-Unis] ; Andrew C. Leon [États-Unis] ; Michael J. Ostacher [États-Unis] ; Noreen Reilly-Harrington [États-Unis]

Source :

Journal of affective disorders [ 0165-0327 ] ; 2014.

RBID : Pascal:14-0252503

Descripteurs français

KwdFr :
- Adulte, Adulte d'âge moyen, Association thérapeutique, Enquêtes et questionnaires, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Lithium (usage thérapeutique), Mâle, Médecine individualisée, Neuroleptiques (usage thérapeutique), Qualité de vie, Résultat thérapeutique, Trouble bipolaire (psychologie), Trouble bipolaire (traitement médicamenteux).
MESH :
- psychologie : Trouble bipolaire.
- traitement médicamenteux : Trouble bipolaire.
- usage thérapeutique : Lithium, Neuroleptiques.
Pascal (Inist)
- Adulte, Adulte d'âge moyen, Association thérapeutique, Enquêtes et questionnaires, Femelle, Guides de bonnes pratiques cliniques comme sujet, Humains, Mâle, Médecine individualisée, Personnalisation, Qualité de vie, Résultat thérapeutique, Traitement, Qualité de vie, Trouble fonctionnel, Trouble bipolaire, Lithium, Normothymique.

English descriptors

KwdEn :
- Adult, Antipsychotic Agents (therapeutic use), Bipolar Disorder (drug therapy), Bipolar Disorder (psychology), Bipolar disorder, Combined Modality Therapy, Customization, Dysfunction, Female, Humans, Lithium, Lithium (therapeutic use), Male, Middle Aged, Mood stabilizer, Practice Guidelines as Topic, Precision Medicine, Quality of Life, Quality of life, Surveys and Questionnaires, Treatment, Treatment Outcome.
MESH :
- chemical , therapeutic use : Antipsychotic Agents, Lithium.
- drug therapy : Bipolar Disorder.
- psychology : Bipolar Disorder.
- Adult, Combined Modality Therapy, Female, Humans, Male, Middle Aged, Practice Guidelines as Topic, Precision Medicine, Quality of Life, Surveys and Questionnaires, Treatment Outcome.

Abstract

Objectives: The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium. Methods: In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus "optimal personalized treatment (OPT)", or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning. Results: Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over 6 months, patients in both treatment groups improved in quality of life and life functioning (p-Values < 0.0001); without a statistically significant difference between the two treatment groups (p-Values > 0.05). Within the lithium group, improvement in quality of life and functioning was not associated with concurrent lithium levels at week 12 or week 24 (p-Values > 0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over 6 months. Conclusions: Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172551

Affiliations:

États-Unis

Le document en format XML

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<term>Antipsychotic Agents (therapeutic use)</term>
<term>Bipolar Disorder (drug therapy)</term>
<term>Bipolar Disorder (psychology)</term>
<term>Bipolar disorder</term>
<term>Combined Modality Therapy</term>
<term>Customization</term>
<term>Dysfunction</term>
<term>Female</term>
<term>Humans</term>
<term>Lithium</term>
<term>Lithium (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Mood stabilizer</term>
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<term>Precision Medicine</term>
<term>Quality of Life</term>
<term>Quality of life</term>
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<term>Treatment Outcome</term>
</keywords>
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<term>Adulte d'âge moyen</term>
<term>Association thérapeutique</term>
<term>Enquêtes et questionnaires</term>
<term>Femelle</term>
<term>Guides de bonnes pratiques cliniques comme sujet</term>
<term>Humains</term>
<term>Lithium (usage thérapeutique)</term>
<term>Mâle</term>
<term>Médecine individualisée</term>
<term>Neuroleptiques (usage thérapeutique)</term>
<term>Qualité de vie</term>
<term>Résultat thérapeutique</term>
<term>Trouble bipolaire (psychologie)</term>
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</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antipsychotic Agents</term>
<term>Lithium</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Bipolar Disorder</term>
</keywords>
<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Trouble bipolaire</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Bipolar Disorder</term>
</keywords>
<keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Trouble bipolaire</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Lithium</term>
<term>Neuroleptiques</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Practice Guidelines as Topic</term>
<term>Precision Medicine</term>
<term>Quality of Life</term>
<term>Surveys and Questionnaires</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Association thérapeutique</term>
<term>Enquêtes et questionnaires</term>
<term>Femelle</term>
<term>Guides de bonnes pratiques cliniques comme sujet</term>
<term>Humains</term>
<term>Mâle</term>
<term>Médecine individualisée</term>
<term>Personnalisation</term>
<term>Qualité de vie</term>
<term>Résultat thérapeutique</term>
<term>Traitement</term>
<term>Qualité de vie</term>
<term>Trouble fonctionnel</term>
<term>Trouble bipolaire</term>
<term>Lithium</term>
<term>Normothymique</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Objectives: The aims of this study were to evaluate correlates and predictors of life functioning and quality of life in bipolar disorder during a comparative effectiveness trial of moderate doses of lithium. Methods: In the Lithium treatment moderate-dose use study (LiTMUS), 283 symptomatic outpatients with bipolar disorder type I or II were randomized to receive lithium plus "optimal personalized treatment (OPT)", or OPT alone. Participants were assessed using structured diagnostic interviews, clinician-rated blinded assessments, and questionnaires. We employ linear mixed effects models to test the effect of treatment overall and adjunct lithium specifically on quality of life or functioning. Similar models are used to examine the association of baseline demographics and clinical features with quality of life and life functioning. Results: Quality of life and impaired functioning at baseline were associated with lower income, higher depressive severity, and more psychiatric comorbid conditions. Over 6 months, patients in both treatment groups improved in quality of life and life functioning (p-Values < 0.0001); without a statistically significant difference between the two treatment groups (p-Values > 0.05). Within the lithium group, improvement in quality of life and functioning was not associated with concurrent lithium levels at week 12 or week 24 (p-Values > 0.05). Lower baseline depressive severity and younger age of onset predicted less improvement in functioning over 6 months. Conclusions: Optimized care for bipolar disorder improves overall quality of life and life functioning, with no additional benefit from adjunct moderate doses of lithium. Illness burden and psychosocial stressors were associated with worse quality of life and lower functioning in individuals with bipolar disorder.</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
</list>
<tree><country name="États-Unis"><noRegion><name sortKey="Sylvia, Louisa G" sort="Sylvia, Louisa G" uniqKey="Sylvia L" first="Louisa G." last="Sylvia">Louisa G. Sylvia</name>
</noRegion>
<name sortKey="Bowden, Charles L" sort="Bowden, Charles L" uniqKey="Bowden C" first="Charles L." last="Bowden">Charles L. Bowden</name>
<name sortKey="Calabrese, Joseph R" sort="Calabrese, Joseph R" uniqKey="Calabrese J" first="Joseph R." last="Calabrese">Joseph R. Calabrese</name>
<name sortKey="Friedman, Edward S" sort="Friedman, Edward S" uniqKey="Friedman E" first="Edward S." last="Friedman">Edward S. Friedman</name>
<name sortKey="Greiter, Elizabeth A" sort="Greiter, Elizabeth A" uniqKey="Greiter E" first="Elizabeth A." last="Greiter">Elizabeth A. Greiter</name>
<name sortKey="Iosifescu, Dan V" sort="Iosifescu, Dan V" uniqKey="Iosifescu D" first="Dan V." last="Iosifescu">Dan V. Iosifescu</name>
<name sortKey="Ketter, Terence" sort="Ketter, Terence" uniqKey="Ketter T" first="Terence" last="Ketter">Terence Ketter</name>
<name sortKey="Leon, Andrew C" sort="Leon, Andrew C" uniqKey="Leon A" first="Andrew C." last="Leon">Andrew C. Leon</name>
<name sortKey="Nierenberg, Andrew A" sort="Nierenberg, Andrew A" uniqKey="Nierenberg A" first="Andrew A." last="Nierenberg">Andrew A. Nierenberg</name>
<name sortKey="Ostacher, Michael J" sort="Ostacher, Michael J" uniqKey="Ostacher M" first="Michael J." last="Ostacher">Michael J. Ostacher</name>
<name sortKey="Rabideau, Dustin J" sort="Rabideau, Dustin J" uniqKey="Rabideau D" first="Dustin J." last="Rabideau">Dustin J. Rabideau</name>
<name sortKey="Reilly Harrington, Noreen" sort="Reilly Harrington, Noreen" uniqKey="Reilly Harrington N" first="Noreen" last="Reilly-Harrington">Noreen Reilly-Harrington</name>
<name sortKey="Thase, Michael E" sort="Thase, Michael E" uniqKey="Thase M" first="Michael E." last="Thase">Michael E. Thase</name>
</country>
</tree>
</affiliations>
</record>

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The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder

The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder

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