The relationship between clinical outcomes and quality of life in first-episode mania: A longitudinal analysis

Erin E. Michalak, Ivan J. Torres, David J. Bond, Raymond W. Lam, Lakshmi N. Yatham

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Objectives: Despite growing attention to the relationship between bipolar disorder (BD) and quality of life (QoL), there remains a lack of information about QoL in the early stages of BD, and about the course of QoL in people with BD over time. Here, we report on QoL and symptomatic outcomes over a 1.5-year period in a Canadian sample of first-episode mania patients. Methods: Patients (n=63) with DSM-IV-TR BD type I recovering from a recent episode of mania were recruited from a university-based hospital setting in Vancouver, BC, Canada and assessed at six monthly intervals for 18months. In addition to symptomatic and cognitive assessments, two self-report QoL scales [the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) and the Medical Outcomes Study Short Form 36 (SF-36)] were administered. Results: Baseline QoL scores were high, with mean Q-LES-Q scores at 70% of the maximum possible score; QoL continued to show a trend towards improvement over time. Multiple hierarchical regressions were used to explore predictors of QoL over time, finding that: (i) length of illness and severity of depressive symptoms at baseline predicted Q-LES-Q scores at both baseline and six months; (ii) the number of previous depressive episodes and severity of depression at baseline and 12months all predicted QoL at 12months; and (iii) only severity of depressive symptoms at 12months predicted QoL at 18months. Conclusions: Our observation that QoL in patients who have recently experienced an episode of mania can be relatively preserved offers hope, both for healthcare providers and for those newly diagnosed. Further, that severity of depressive symptoms even in the early stages of the disease was the consistent predictor of QoL suggests that depressive symptoms need to be aggressively treated to improve QoL.

Original languageEnglish (US)
Pages (from-to)188-198
Number of pages11
JournalBipolar Disorders
Issue number2
StatePublished - Mar 2013


  • Bipolar disorder
  • First-episode mania
  • Longitudinal
  • Quality of life


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