Improving QoL for bipolar patients: treatment of different and complex phases of illness

Until recently, most systematic studies in bipolar disorder concentrated on reduction of illness severity as the primary outcome measure. However, functional disabilities even in euthymic phases are a key issue [1] and improving quality of life in different domains as work, family and social activities appears to be of utmost importance for patients as a recent WHO survey shows. Especially in bipolar depression, functionality of patients appears severely impaired throughout several domains [2]. As demonstrated by Hirschfeld et al. [3] this impairment appears more severe in bipolar compared to unipolar depression. Thus, not only reducing depressive symptomatology but also improving quality of life should be a primary target for any new treatment option, both pharmacological and non-pharmacological. Psychotherapy, even just psychoeducation, can clearly improve coping with the illness and by this also improve quality of life [4]. In addition, some new pharmacological treatment options as the atypical antipsychotic quetiapine could demonstrate that they are not only improving depressive symptomatology in bipolar depression, but also significantly improve quality of life as measured with the Q-LES-Q (Quality of Life Enjoyment and Satisfaction Questionnaire: 16-item short form [5]).

Measuring quality of life as a important outcome parameter in controlled studies may contribute to make those studies and new medications also more meaningful for patients.