PittsburghV1, PascalFrancis, Checkpoint, bibRecord, 000145

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

Identifieur interne : 000145 ( PascalFrancis/Checkpoint ); précédent : 000144; suivant : 000146

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

Pascal (Inist)
- Personnalisation, Traitement, Qualité de vie, Trouble fonctionnel, Trouble bipolaire, Lithium, Normothymique.

English descriptors

KwdEn :
- Bipolar disorder, Customization, Dysfunction, Lithium, Mood stabilizer, Quality of life, Treatment.

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.

Affiliations:

États-Unis

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<author><name sortKey="Ketter, Terence" sort="Ketter, Terence" uniqKey="Ketter T" first="Terence" last="Ketter">Terence Ketter</name>
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<author><name sortKey="Leon, Andrew C" sort="Leon, Andrew C" uniqKey="Leon A" first="Andrew C." last="Leon">Andrew C. Leon</name>
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<author><name sortKey="Reilly Harrington, Noreen" sort="Reilly Harrington, Noreen" uniqKey="Reilly Harrington N" first="Noreen" last="Reilly-Harrington">Noreen Reilly-Harrington</name>
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<series><title level="j" type="main">Journal of affective disorders</title>
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<term>Quality of life</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Personnalisation</term>
<term>Traitement</term>
<term>Qualité de vie</term>
<term>Trouble fonctionnel</term>
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<term>Lithium</term>
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<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>
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<fA11 i1="01" i2="1"><s1>SYLVIA (Louisa G.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>RABIDEAU (Dustin J.)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>NIERENBERG (Andrew A.)</s1>
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<fA11 i1="04" i2="1"><s1>BOWDEN (Charles L.)</s1>
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<fA11 i1="05" i2="1"><s1>FRIEDMAN (Edward S.)</s1>
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<fA11 i1="06" i2="1"><s1>IOSIFESCU (Dan V.)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>THASE (Michael E.)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>KETTER (Terence)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>GREITER (Elizabeth A.)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>CALABRESE (Joseph R.)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>LEON (Andrew C.)</s1>
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<fA11 i1="12" i2="1"><s1>OSTACHER (Michael J.)</s1>
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<fA11 i1="13" i2="1"><s1>REILLY-HARRINGTON (Noreen)</s1>
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<fA14 i1="03"><s1>University of Pittsburgh School of Medicine</s1>
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<fA14 i1="06"><s1>Stanford University</s1>
<s3>USA</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Case Western Reserve University School of Medicine</s1>
<s3>USA</s3>
<sZ>10 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Weill Cornell Medical College</s1>
<s3>USA</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>VA Palo Alto Health Care System and Stanford University</s1>
<s3>USA</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA20><s1>144-148</s1>
</fA20>
<fA21><s1>2014</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
</fA23>
<fA43 i1="01"><s1>INIST</s1>
<s2>18006</s2>
<s5>354000502640440210</s5>
</fA43>
<fA44><s0>0000</s0>
<s1>© 2014 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>1/4 p.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>14-0252503</s0>
</fA47>
<fA60><s1>P</s1>
<s3>CC</s3>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Journal of affective disorders</s0>
</fA64>
<fA66 i1="01"><s0>GBR</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>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.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B18C07C</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B02B02</s0>
</fC02>
<fC02 i1="03" i2="X"><s0>002B18C07D</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Personnalisation</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Customization</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Personalización</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Traitement</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Treatment</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Tratamiento</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Qualité de vie</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Quality of life</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Calidad vida</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Trouble fonctionnel</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Dysfunction</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Trastorno funcional</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Trouble bipolaire</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Bipolar disorder</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Trastorno bipolar</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Lithium</s0>
<s2>NC</s2>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Lithium</s0>
<s2>NC</s2>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Litio</s0>
<s2>NC</s2>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Normothymique</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Mood stabilizer</s0>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Estabilizador humor</s0>
<s5>07</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Trouble de l'humeur</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Mood disorder</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Trastorno humor</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Psychotrope</s0>
<s2>FX</s2>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Psychotropic</s0>
<s2>FX</s2>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Psicotropo</s0>
<s2>FX</s2>
<s5>38</s5>
</fC07>
<fN21><s1>307</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
</inist>
<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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