The Relationship between Predominant Polarity, Lifetime Comorbid Anxiety Disorders and Subjective Quality of Life among Individuals with Bipolar Disorder in Singapore

Background: Depressive features and comorbid anxiety disorders are two discrete but interconnected clinical features that have been reported to be associated with a poorer quality of life (QoL) among individuals with bipolar disorders. However, the relationship between manic features and quality of life is less conclusive. The present study aimed to assess differences in QoL among bipolar outpatients who present with either depressive predominant polarity (DPP), manic predominant polarity (MPP) and/or a lifetime diagnosis of comorbid anxiety disorders in Singapore. Methods: Data from 74 outpatients in Singapore diagnosed with bipolar disorder were collected. Sociodemographic information, the polarity of most episodes (2 out of 3), the diagnosis of anxiety disorders and QoL were obtained from a self-reported interview and/or through clinical records. QoL was measured using the abbreviated version of the World Health Organization questionnaire. We used multivariate regression models to determine the relationships between predominant polarity, lifetime comorbid anxiety disorders and QoL in physical health, psychological health, social relationships and environment domains. Results: After adjusting for covariates, individuals with DPP scored poorer for WHOQOL-BREF for all four domains as compared with individuals with indeterminate polarity. As compared to individuals with indeterminate polarity, individuals with MPP scored poorer for WHOQOL-BREF social relationships. Lastly, individuals with lifetime comorbid anxiety disorders scored poorer for WHOQOL-BREF physical health, social relationships and environment. Discussion and Conclusions: The present study provides preliminary support for the relationship between DPP, lifetime comorbid anxiety disorders and poorer QoL, paving the pathway for future research with larger samples to utilise our study design to verify our results.