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

Identifieur interne : 004139 ( PascalFrancis/Curation ); précédent : 004138; suivant : 004140

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 :

RBID : Pascal:14-0252503

Descripteurs français

English descriptors

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.
pA  
A01 01  1    @0 0165-0327
A02 01      @0 JADID7
A03   1    @0 J. affect. disord.
A05       @2 169
A08 01  1  ENG  @1 The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder
A11 01  1    @1 SYLVIA (Louisa G.)
A11 02  1    @1 RABIDEAU (Dustin J.)
A11 03  1    @1 NIERENBERG (Andrew A.)
A11 04  1    @1 BOWDEN (Charles L.)
A11 05  1    @1 FRIEDMAN (Edward S.)
A11 06  1    @1 IOSIFESCU (Dan V.)
A11 07  1    @1 THASE (Michael E.)
A11 08  1    @1 KETTER (Terence)
A11 09  1    @1 GREITER (Elizabeth A.)
A11 10  1    @1 CALABRESE (Joseph R.)
A11 11  1    @1 LEON (Andrew C.)
A11 12  1    @1 OSTACHER (Michael J.)
A11 13  1    @1 REILLY-HARRINGTON (Noreen)
A14 01      @1 Massachusetts General Hospital, 50 Staniford Street, Suite 580 @2 Boston, MA 02114 @3 USA @Z 1 aut. @Z 2 aut. @Z 3 aut. @Z 9 aut. @Z 13 aut.
A14 02      @1 University of Texas Health Science Center @2 San Antonio @3 USA @Z 4 aut.
A14 03      @1 University of Pittsburgh School of Medicine @3 USA @Z 5 aut.
A14 04      @1 Mount Sinai School of Medicine @3 USA @Z 6 aut.
A14 05      @1 University of Pennsylvania School of Medicine @3 USA @Z 7 aut.
A14 06      @1 Stanford University @3 USA @Z 8 aut.
A14 07      @1 Case Western Reserve University School of Medicine @3 USA @Z 10 aut.
A14 08      @1 Weill Cornell Medical College @3 USA @Z 11 aut.
A14 09      @1 VA Palo Alto Health Care System and Stanford University @3 USA @Z 12 aut.
A20       @1 144-148
A21       @1 2014
A23 01      @0 ENG
A43 01      @1 INIST @2 18006 @5 354000502640440210
A44       @0 0000 @1 © 2014 INIST-CNRS. All rights reserved.
A45       @0 1/4 p.
A47 01  1    @0 14-0252503
A60       @1 P @3 CC
A61       @0 A
A64 01  1    @0 Journal of affective disorders
A66 01      @0 GBR
C01 01    ENG  @0 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.
C02 01  X    @0 002B18C07C
C02 02  X    @0 002B02B02
C02 03  X    @0 002B18C07D
C03 01  X  FRE  @0 Personnalisation @5 01
C03 01  X  ENG  @0 Customization @5 01
C03 01  X  SPA  @0 Personalización @5 01
C03 02  X  FRE  @0 Traitement @5 02
C03 02  X  ENG  @0 Treatment @5 02
C03 02  X  SPA  @0 Tratamiento @5 02
C03 03  X  FRE  @0 Qualité de vie @5 03
C03 03  X  ENG  @0 Quality of life @5 03
C03 03  X  SPA  @0 Calidad vida @5 03
C03 04  X  FRE  @0 Trouble fonctionnel @5 04
C03 04  X  ENG  @0 Dysfunction @5 04
C03 04  X  SPA  @0 Trastorno funcional @5 04
C03 05  X  FRE  @0 Trouble bipolaire @5 05
C03 05  X  ENG  @0 Bipolar disorder @5 05
C03 05  X  SPA  @0 Trastorno bipolar @5 05
C03 06  X  FRE  @0 Lithium @2 NC @5 06
C03 06  X  ENG  @0 Lithium @2 NC @5 06
C03 06  X  SPA  @0 Litio @2 NC @5 06
C03 07  X  FRE  @0 Normothymique @5 07
C03 07  X  ENG  @0 Mood stabilizer @5 07
C03 07  X  SPA  @0 Estabilizador humor @5 07
C07 01  X  FRE  @0 Trouble de l'humeur @5 37
C07 01  X  ENG  @0 Mood disorder @5 37
C07 01  X  SPA  @0 Trastorno humor @5 37
C07 02  X  FRE  @0 Psychotrope @2 FX @5 38
C07 02  X  ENG  @0 Psychotropic @2 FX @5 38
C07 02  X  SPA  @0 Psicotropo @2 FX @5 38
N21       @1 307
N44 01      @1 OTO
N82       @1 OTO

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Pascal:14-0252503

Le document en format XML

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<title xml:lang="en" level="a">The effect of personalized guideline-concordant treatment on quality of life and functional impairment in bipolar disorder</title>
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<name sortKey="Ketter, Terence" sort="Ketter, Terence" uniqKey="Ketter T" first="Terence" last="Ketter">Terence Ketter</name>
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<name sortKey="Calabrese, Joseph R" sort="Calabrese, Joseph R" uniqKey="Calabrese J" first="Joseph R." last="Calabrese">Joseph R. Calabrese</name>
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<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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<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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