Subjective well-being nel disturbo bipolare : uno studio prospettico preliminare

Aims: Recently numerous studies have focused their attention on the importance of patients' self evaluation of the impact of pharmacotherapy on quality of life. These aspects have led to the introduction of new assessments in psychiatric care in order to help clinicians in evaluating patients' perspective and subjective well-being. To date, several studies have investigated subjective well-being among schizophrenic patients, whereas there are few such studies in bipolar patients. This study aims at evaluating the association between subjective well-being and psychopathology in bipolar patients subjected to drug treatment with atypical antipsychotics and mood stabilizers at the time of admission to the psychiatric ward and during a follow-up period. Methods: A consecutive sample of thirty in-patients with a diagnosis of bipolar disorder (DSM IV-TR) was recruited in the psychiatric ward of the Fondazione IRCCS "Ca' Granda" Ospedale Maggiore Policlinico, Milan. They were studied on admission (TO), at discharge (T1) and then at 6 (T2), 12 (T3) and 18 weeks (T4) after discharge (Fig. 1). Psychopathology was rated with the Brief Psychiatric Rating Scale (BPRS), while subjective well-being was assessed with the Subjective Well-being under Neuroleptic treatment scale (SWN). Associations between BPRS and SWN scores were analyzed using Pearson's correlation coefficients. In addition, a linear regression analysis was conducted using SWN at the end of follow-up (T4) as the dependent variable and demographic and clinical characteristics as possible predictors. Results: Non-linear relations best described the associations between changes in BPRS and SWN scores over time: no association was found during the acute phase (from admission to T1), while cross-sectional Pearson's correlation coefficients indicate inverse associations between SWN and BPRS scores at T2 (r = -0.598, p = 0.014) and between SWN at T2 and BPRS score at T4 (r = -0.84 7, p = 0.009) (Table I). Moreover, linear regression showed that variance in SWN at T4 was mostly accounted for by the effect of number of admissions (standardized B -0.551, p = 0.021) and SWN score at T2 (standardized B 1.262; p = 0.001) (Table II). Conclusions: Our results point-out that modifications in subjective well-being and psychopathological state were not linearly related in bipolar patients, thus suggesting that subjective well-being could be considered in these patients as a personal variable associated to psychopathological state in a different way according to phase of illness. Further research including wider samples and longer follow-up periods are needed in to confirm our results and identify other possible correlations.