Moving beyond bipolar “misery statistics”

on July 25, 2013   |    1 comment

Have you ever read a scientific paper on bipolar disorder? The majority begin in much the same way, with what our team members at the Spectrum Centre for Mental Health Research describe as “bipolar misery statistics.” These stats describe the lethal, disabling, and costly (at a personal and societal level) impacts of bipolar disorders. And, to an extent, these statistics are true. Findings from a study of Swedish adults, published in JAMA Psychiatry, showed people with bipolar disorder die, on average, nine years younger than people in the general population. Bipolar disorder is associated with high rates of suicide and can lead to terrible distress, additional chronic health conditions, cognitive dysfunction and disability. As a consequence, it also produces inordinate costs to the Canadian healthcare system.

But is this all of the picture? One of the problems with these “misery statistics” and the manner in which they’re presented is that they’re not nuanced enough to describe the substantial gaps that exist in the bipolar disorders research field.  For example, on the whole, they’re derived from studies of people who have experienced bipolar disorder for many years, or have not had the benefit of optimal, evidence-based treatments meeting guidelines such as those produced by the Canadian Network  for Mood and Anxiety Treatments. A specific gap exists in terms of what we know about health and wellbeing in people who are in the early stages of bipolar disorder, despite the fact the condition often presents during adolescence or early adulthood.

It was with this in mind that CREST.BD network member Dr. Lakshmi Yatham established the Systematic Treatment Optimization Program for Early Mania (or “STOP-EM”) program at the University of British Columbia (UBC) in Vancouver.  STOP-EM was specifically designed to gather knowledge on outcomes in younger people (aged 14-35) with bipolar disorder who had recently experienced their first episode of mania.  The data that STOP-EM is producing is potentially useful to the field of bipolar disorders research. Here’s why:

  • It’s real world, providing information on what happens to younger people with bipolar disorder when they receive guideline-driven treatment in a natural setting;
  • It’s longitudinal, giving us information about how these people fare over long periods of time (i.e., years rather than months);
  • The people in the project had recently experienced their first episode of full mania. In contrast, most bipolar disorder research samples include people who have had multiple episodes of depression and mania; untangling “what’s causing what”in such studies can be tough.

So, does STOP-EM add to the ‘misery statistics’ in terms of what outcomes look like in younger people recently admitted to hospital for a manic episode? Not so much. In fact, we found that perceived quality of life in the sample was high – almost in the same range as you would expect to find in the general population. More recently, a study in the Journal of Affective Disorders describes quality of life experiences in those who have experienced their first episode of psychotic mania. The results indicate that people in this instance can maintain their quality of life, and it can be improved going forward when psychosocial treatment is given due care by healthcare providers.

Interested in learning more? You can find our published paper on quality of life in the first 63 people involved in the STOP-EM project over 18 months here.

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