Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder

Gomes, Bernardo Carramão; Kleinman, Ana; Carvalho, Alex Franco de; Pereira, Tatiana Couto F.; Gurgel, Ana Paola; Lafer, Beny; Busatto, Geraldo F.; Caetano, Sheila C.; Rocca, Cristiana Castanho de Almeida

doi:10.1016/j.jad.2016.05.041

Cited by 14 publications

(18 citation statements)

References 24 publications

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“…Lower QoL is associated with a greater risk for suicidal behavior in adults with BD (de Abreu et al, 2012). A study examining health values (i.e., subjective satisfaction, distress, and undesirability of having a health condition) among adult outpatients with BD found that, on average, patients were willing to give up 39% of their life expectancy for a healthier mental state than their current one (Tsevat et al, 2000) Relatedly, childhood-onset patients with BD have lower QoL in the areas of psychosocial, physical, and emotional well-being compared to children with major depression, anxiety disorders, disruptive behavior disorders, or no psychiatric history (Freeman et al, 2009; Gomes et al, 2016; Rademacher et al, 2007; Stewart et al, 2009). …”

Section: Introductionmentioning

confidence: 99%

Enhancing quality of life among adolescents with bipolar disorder: A randomized trial of two psychosocial interventions

O’Donnell

Axelson

Kowatch

et al. 2017

Journal of Affective Disorders

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Background Adolescents with bipolar disorder (BD) report lower quality of life (QoL) than adolescents with other psychiatric disorders. This study compared the efficacy of family-focused therapy for adolescents (FFT-A) plus pharmacotherapy to brief psychoeducation (enhanced care, or EC) plus pharmacotherapy on self-rated QoL in adolescents with BD over 2 years. Methods Participants were 141 adolescents (mean age: 15.6 ± 1.4yr) with BD I or II who had a mood episode in the previous 3 months. Adolescents and parents were randomly assigned to (1) FFT-A, given in 21 sessions in 9 months of psychoeducation, communication enhancement training, and problem-solving skills training, or (2) EC, given in 3 family psychoeducation sessions. Study psychiatrists provided patient participants with protocol-based pharmacotherapy for the duration of the study. QoL was assessed with The KINDLR Questionnaire (Ravens-Sieberer and Bullinger, 1998) during active treatment (baseline to 9 months) and during a post-treatment follow-up (9–24 months). Results The two treatment groups did not differ in overall QoL scores over 24 months. However, adolescents in FFT-A had greater improvements in quality of family relationships and physical well-being than participants in EC. For quality of friendships, the trajectory during active treatment favored EC, whereas the trajectory during post-treatment favored FFT-A. Limitations We were unable to standardize medication use or adherence over time. Quality of life was based on self-report rather than on observable functioning. Conclusions A short course of family psychoeducation and skills training may enhance relational functioning and health in adolescents with BD. The effects of different psychosocial interventions on peer relationships deserves further study.

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Section: Introductionmentioning

confidence: 99%

Enhancing quality of life among adolescents with bipolar disorder: A randomized trial of two psychosocial interventions

O’Donnell

Axelson

Kowatch

et al. 2017

Journal of Affective Disorders

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“…Patients with bipolar I or II disorders often experience depressive symptoms, including time to clinical remission longer than either hypomanic or manic episodes 1–3. Depressive episodes in bipolar disorders are associated with significant impairment of various occupational, academic, and social functioning, negative effects on the quality of life, and mortality of children and adolescents 4,5. However, a limited number of clinically controlled studies indicated the efficacy of pharmacological treatment for children and adolescents diagnosed with bipolar disorder 6–8…”

Section: Introductionmentioning

confidence: 99%

Quetiapine monotherapy versus placebo in the treatment of children and adolescents with bipolar depression: a systematic review and meta-analysis

Maneeton

Putthisri

Maneeton

et al. 2017

NDT

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BackgroundSome studies have indicated the efficacy of quetiapine in the treatment of bipolar depression in adult patients. However, its efficacy has been not shown in child and adolescent patients.ObjectiveThis systematic review purposefully determined the efficacy and acceptability of quetiapine in the treatment of children and adolescents with bipolar depression.Data sourcesA database search of EMBASE, PubMed, CINAHL, and Cochrane Controlled Trials Register was carried out in March 2016. All randomized controlled trials (RCTs) of bipolar depression in children and adolescents were considered for inclusion in this review.Study eligibility criteria, participants, and interventionsRCTs of quetiapine in the treatment of child and adolescent patients with bipolar depression with end point outcomes were included in this study. Languages were not limited.Study appraisal and synthesis methodsThe full-text versions of relevant clinical studies were thoroughly examined and extracted. The primary efficacy of outcome was measured by using the pooled mean-changed scores of the rating scales for bipolar depression. However, the response and remission rates were also measured.ResultsA total of 251 randomized patients in the three RCTs of quetiapine versus placebo in the treatment of bipolar depression for children and adolescents were eligible in this review. The pooled mean-changed score of the quetiapine-treated group was not greater than that of the placebo-treated group. Similarly, the pooled response and remission rates were not different between the two groups. The pooled overall discontinuation rate and the discontinuation rate due to adverse events were not different between the two groups.LimitationsLimited studies were eligible in this review.ConclusionAccording to the findings in this review, quetiapine may not be efficacious in the treatment of bipolar depression in children and adolescents. Its acceptability, however, was comparable to a placebo. Therefore, the use of quetiapine in children and adolescents with bipolar depression is not recommended. Further well-defined clinical studies should be performed to confirm these outcomes.

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“…There is a significant reduction in quality of life (QoL) in youth with bipolar disorder [5–7], with patients experiencing social and attention problems, delinquent and aggressive behavior, and a poor ability to maintain stable relationships and perform successfully at work or school [8–12]. Improving the QoL of patients with bipolar disorder is an important aspect of a successful treatment outcome.…”

Section: Introductionmentioning

confidence: 99%

Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination

Walker

DelBello

Landry

et al. 2017

Child Adolesc Psychiatry Ment Health

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BackgroundWe examined the efficacy of olanzapine/fluoxetine combination (OFC) in improving health-related quality of life (QoL) in the treatment of bipolar depression in children and adolescents.MethodsPatients aged 10–17 years with bipolar I disorder, depressed episode, baseline children’s depression rating scale-revised (CDRS-R) total score ≥40, Young Mania Rating Scale (YMRS) total score ≤15, and YMRS-item 1 ≤ 2 were randomized to OFC (6/25–12/50 mg/day olanzapine/fluoxetine; n = 170) or placebo (n = 85) for up to 8 weeks of double-blind treatment. Patients and parents completed the revised KINDL questionnaire for measuring health-related QoL in children and adolescents (KINDL-R) at baseline and endpoint. The mean change in CDRS-R total and item scores were used to compare improvement in symptomatology in patients taking OFC and placebo. Tests were 2-sided using a Type I error cutoff of 0.05, and no adjustments for multiple comparisons were made.ResultsBaseline QoL as measured by the KINDL-R was substantially impaired relative to published norms for a healthy school-based sample. OFC-treated patients demonstrated an improvement over placebo at endpoint with respect to mean change from baseline in the patient-rated KINDL-R Self-esteem subscale score (p = 0.028), and in the parent KINDL-R ratings of emotional well-being (p = 0.020), Self-esteem (p = 0.030), and Family (p = 0.006). At endpoint, OFC-treated patients still had a lower QoL compared to the normative population. OFC showed significant improvement (p ≤ 0.05) versus placebo on the CDRS-R total score and on 7 of the 17 CDRS-R items.ConclusionsPatients aged 10–17 years with an acute episode of bipolar depression and their parents reported greater improvements (parents noticed improvements in more areas than did their offspring) on some aspects of QoL when treated with OFC compared with placebo. However, after 8 weeks of treatment, KINDL-R endpoint scores remained lower than those of the, presumably healthy, control population. Clinical trial registration information A Study for Assessing Treatment of Patients Ages 10–17 with Bipolar Depression; http://www.clinicaltrials.gov; NCT00844857

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Quality of life in youth with bipolar disorder and unaffected offspring of parents with bipolar disorder

Cited by 14 publications

References 24 publications

Enhancing quality of life among adolescents with bipolar disorder: A randomized trial of two psychosocial interventions

Enhancing quality of life among adolescents with bipolar disorder: A randomized trial of two psychosocial interventions

Quetiapine monotherapy versus placebo in the treatment of children and adolescents with bipolar depression: a systematic review and meta-analysis

Quality of life in children and adolescents with bipolar I depression treated with olanzapine/fluoxetine combination

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