A cross-sectional comparison of disability and quality of life in euthymic patients with bipolar affective or recurrent depressive disorder with and without comorbid chronic medical illness

BACKGROUND: There are major health care implications of quality of life (QOL) and disability in long-standing disorders such as bipolar affective disorder (BAD) and recurrent depressive disorder (RDD). OBJECTIVES: To compare the inter-episode QOL and disability in patients with the diagnosis of BAD or RDD in remission with and without comorbid chronic medical illness. MATERIALS AND METHODS: Cross-sectional assessments of the four groups were carried out. Euthymic bipolar or RDD subjects with chronic comorbid medical illnesses were included in the study. QOL assessment was carried out using the World Health Organization (WHO)-QOL - Bref Kannada version. Disability was assessed using the Schedule for Assessment of Psychiatric Disability (SAPD), which is an Indian modification of the WHO Disability Assessment Schedule-II. RESULTS: Eighty patients were enrolled into the study (20 patients in each group). The mean disability scores in the BAD group was significantly more in ‘social role’ (P = 0.038), and in the RDD group it was more in ‘home atmosphere’ (P = 0.001) in the two groups (n = 40) with chronic comorbid medical illness. In the other group without comorbid chronic medical illness (n = 40), the BAD group had significantly more disability in ‘overall behavior’ (P = 0.002) and ‘social role’ (P = 0.001), and the RDD group had significantly more disability in ‘assets and/or liabilities’ (P = 0.004) and ‘home atmosphere’ (P = 0.001). The QOL measures did not differ significantly between the two disorders. CONCLUSIONS: The presence of chronic comorbid medical illness did not cause a difference in the QOL between the two groups in periods of euthymia. However, disability measures differed significantly between the groups.