File(s) under permanent embargo
Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder
journal contribution
posted on 2017-05-01, 00:00 authored by Lesley BerkLesley Berk, Karen Hallam, Kamalesh Venugopal, Andrew Lewis, David AustinDavid Austin, J Kulkarni, Seetal DoddSeetal Dodd, A de Castella, P B Fitzgerald, Michael BerkMichael BerkObjectives
Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder.
Methods
We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) – a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables.
Results
At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity.
Conclusions
Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder.
Methods
We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) – a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables.
Results
At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity.
Conclusions
Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
History
Journal
Bipolar disordersVolume
19Issue
3Pagination
184 - 197Publisher
WileyLocation
Hoboken, N.J.Publisher DOI
ISSN
1398-5647eISSN
1399-5618Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2017, WileyUsage metrics
Read the peer-reviewed publication
Categories
Keywords
bipolar disorderdepressionfunctioningirritabilitymaniapsychiatryquality of lifeschizoaffective disordersocial supportsuicideScience & TechnologyLife Sciences & BiomedicineClinical NeurologyNeurosciencesNeurosciences & NeurologyQUALITY-OF-LIFEAFFECTIVE REACTIVITY INDEXMAJOR DEPRESSIVE EPISODESTASK-FORCE REPORTSUICIDE ATTEMPTSMANIC SYMPTOMSRISK-FACTORSFOLLOW-UPSTEP-BDAFFECTIVE TEMPERAMENTS