Health-related Quality of Life Among Patients With Bipolar Disorder in Rural Southwestern Uganda: A Hospital Based Cross Sectional Study

Abstract

Background: Bipolar disorder is a psychiatric disorder that alters mood and affects over 55 million people globally with an estimated lifetime prevalence of approximately 0.8 - 1.1%. In Africa, the lifetime prevalence of the bipolar spectrum disorders is slightly lower at 0.1 – 0.6%. Bipolar disorder is ranked the sixth leading cause of disability with high rates of morbidity and mortality and negatively impacts quality of life of those affected. Methods: The aim of the study was to determine the health-related quality of life of patients with bipolar disorder attending a mental health clinic in south western Uganda. We enrolled a consecutive sample of 169 participants and evaluated their health-related quality of life using the medical outcomes health survey short form-36 (SF-36) scale. We used bivariate and multivariable logistic regression to determine associations between quality of life, sociodemographic and clinical factors setting the physical and mental component categories of quality life scale as the main outcome variables. Results: The mean age of the participants was 37.23 (12.83) and slightly over half (54.4%) were females. More than half (66.86%) of the participants had poor physical component summary (mean=45.06, SD=8.44) while 81% of the participants had poor mental component summary (mean=41.95, SD=8.45). Poor physical quality of life had a statistically significant association with history of suicidal thoughts (OR=2.75, 95% CI=1.14-6.63, P=0.02), while poor mental quality of life had a statistically significant association with history of suicidal thoughts (OR=3.94, CI=1.22-12.71, P=0.02) and history of psychotic symptoms (OR=2.46, CI=1.07-5.64, P=0.03).Conclusion: The mental and physical quality of life of our participants was poor and history of suicidal thoughts and psychotic symptoms were associated with poor quality of life. There is need to address psychotic symptoms and suicidal thoughts in the management of patients with bipolar disorder to improve health related outcomes and quality of life.