Quality of Life of Participants with Bipolar and Schizoaffective Disorder in an Australian Cohort after 24 months

  • Anthony de Castella, The Alfred and Monash University, Australia
  • Jayashri Kulkarni, The Alfred and Monash University, Australia
  • Prof Michael Berk, Barwon Health, University of Melbourne, Australia
  • Paul Fitzgerald, The Alfred and Monash University, Australia
  • Kate Filia, The Alfred and Monash University, Australia
  • Dr Seetal Dodd, Department of Clinical and Biomedical Sciences University of Melbourne, Australia
  • Lesley Berk, ORYGEN Research Centre, University of Melbourne, Australia
  • Sacha Filia, The Alfred and Monash University, Australia
  • William Montgomery, Eli Lilly Australia Pty Ltd, Australia
  • A/Prof Meg Smith, University of Western Sydney, Australia
  • K Wang, Intercontinental Information Sciences, Eli Lilly Australia Pty Ltd, Australia
  • A Meyers, Lilly Research Laboratories, Eli Lilly and Company, United States
  • Alan Brnabic, Intercontinental Information Sciences, Eli Lilly Australia Pty Ltd, Australia
  • RE Granger, Intercontinental Information Sciences, Eli Lilly Australia Pty Ltd, Australia
  • Katarina Kelin, Eli Lilly Australia Pty Ltd, Australia

    • Introduction: The Bipolar Comprehensive Outcomes Study (BCOS) is a 2-year, prospective, open-label, observational study of participants with bipolar I or schizoaffective disorder, conducted in two study centres in Victoria, Australia. BCOS aims to improve understanding of the clinical, functional, and economic outcomes associated with real-life treatment.
    Methods: Participants (N=239) prescribed mood stabilisers were assessed at 3-month intervals. Here we report longitudinal 24-month quality of life data for the overall study population, as assessed by the EuroQol instrument (EQ-5D), the 36-Item Short-Form Health Survey (SF-36), DIP (Diagnostic Interview for Psychosis) and SLICE/LIFE questionnaire.
    Results: Participants' overall health state improved after 24 months according to EQ-5D overall scores ([mean±SE] 71.1±1.20 vs. 66.4±1.30 baseline, best imaginable health state 100, p<.001), although EQ-5D utility scores were relatively unchanged (0.77±0.02 vs. 0.74±0.02, perfect health 1, p=.024). Overall SF-36 mental component scores also improved (41.2±0.97 vs. 36.8±0.84, population norm 50, p=.032) although physical component scores remained similar to baseline estimates (46.9±0.72 vs. 46.7±0.68, p=.667). Self-reported overall (SLICE/LIFE total: 2.17±0.05 vs. 2.42±0.04, maximum possible score 5, p<.001), work (2.16±0.08 vs. 2.55±0.07, p<.001) and familial interpersonal (2.37±0.07 vs. 2.59±0.08, p=.014) quality of life significantly improved. After 24 months, more participants indicated that they were satisfied/very satisfied with life (57.8% vs. 46.8% baseline), and an increased proportion of participants reported enjoyment of recreational activities (49.3% vs. 36.4%). The unemployment rate had decreased (23.1% vs. 29.3%), mental illness prevented fewer participants from working (7.6% vs. 17.6%), and the overall severity of work impairment was reduced (28.0% vs. 16.3% no impairment). During the study, 43.9% of participants were hospitalised at least once, staying an average of 35.0 days, although 43.8% of hospitalisations were for 1 day only.
    Discussion: The results suggest that people who are prescribed treatment for bipolar and schizoaffective disorders largely experience improved or unchanged quality of life after 24 months of observation. BCOS provides essential information regarding a broad range of outcomes for individuals receiving long-term pharmacological treatment for bipolar and schizoaffective disorders.

    Supported by funding from Eli Lilly.