Impact of subdepressive simptoms in quality of life of bipolar patients from mood disorder clinic of Instituto Psiquiatrico "Dr. José Horwitz B", Santiago, Chile
Objective: To characterize quality of life, social role and interpersonal relationships of bipolar patients comparing with the presence or absence of subsyndromal depressive/hypomanic symptoms. Method: 91 bipolar I and II outpatients from Mood Disorders Clinic of Instituto Psiquiátrico “Dr. José Horwitz”, Santiago, Chile; whom completed the Outcome Questionnaire 45.2(OQ 45.2) and the Patient Health Questionnaire-9(PHQ-9). Clinicians completed Young Manic Rating Scale (YMRS). Results: 91 outpatients, 67 (76.3%) women, and 24 men (26.4%). The average age was 51 years (SD 13,8) corresponding to BPD I 73.0%, BPD II 20.2% and BPD NOS 2.2%. According to YMRS 87.5% of the patients were asymptomatic, 13.2% mixed and 1% maniacal. PHQ-9 found that 23.3% were euthimic, 23.3% sub depressive, 21.1 % mild depressive, 20.0% moderate depressive and 12.2% severe depressive. In the OQ-45 42.4% of the patients had clinically significant discomfort, 45.3% had anxious-depressive symptoms, 49.4% had social problems and 28.4% had difficulties in social role. Sub depressive patients (n = 19) presented 10.5% of general discomfort, 15.5% had clinical symptoms, 20.0% had social relationship problems, and 14.3% difficulties in social role (OQ-45). OQ found significant differences (p < 0.005) between sub depressive, moderate and severe depressive patients. However, in contrast with patients with mild depression, sub depressive ones appear without significant difference in social role adjustment sub-scale. Conclusion: subdepressive symptoms significantly impact quality of life of patients in this sample. Worsening in social role scale could be an early predictor of relapse into a depressive phase in this group of patients.