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Provencher MD, Morton E, Beaudoin AS, Guillemette J, Rheault E, Mérette C, Coque L, Hawke LD, Michalak EE. The Quality of Life in Bipolar Disorder (QoL.BD) Scale: Validation of a French Cross-Cultural Adaptation. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2021; 66:298-305. [PMID: 32783472 PMCID: PMC7958201 DOI: 10.1177/0706743720948663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE The goal of this study was to validate the French version of the Quality of Life in Bipolar Disorder (QoL.BD) scale, a condition-specific measure for bipolar disorder (BD). METHOD The QoL.BD scale was translated into French in accordance with the recommendations for transcultural adaptation. It was administered to 125 participants with BD living in Quebec, Canada. Construct validity was evaluated through correlations with other measures of self-reported quality of life (QoL), functioning, and symptoms. Factorial structure was examined through an exploratory factor analysis. RESULTS Internal reliability and test-retest reliability standards were met. Correlations in expected directions with other QoL, functioning, and depressive symptom scales supported convergent validity. The item loadings structure of the French QoL.BD largely replicated the original English version, with some modifications. CONCLUSION The French version of the QoL.BD (full and brief) is comparable in its psychometric properties to the English version. It is a valid and sound measure for the evaluation of the QoL of French-speaking patients with BD.
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Affiliation(s)
- Martin D Provencher
- École de psychologie, 332917Université Laval, Québec, Canada.,Centre de recherche CERVO, Québec, Canada
| | - Emma Morton
- Division of Mood Disorders, Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Evelyne Rheault
- Département de psychiatrie, 4440Université Laval, Québec, Canada
| | - Chantal Mérette
- Centre de recherche CERVO, Québec, Canada.,Faculté de médecine, Département de Psychiatrie et de neuroscience, 4440Université Laval, Québec, Canada
| | - Laurent Coque
- Division of Mood Disorders, Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Lisa D Hawke
- 7978Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Erin E Michalak
- Division of Mood Disorders, Department of Psychiatry, 8166University of British Columbia, Vancouver, British Columbia, Canada
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The Quality of Life in Bipolar Disorder (QoL.BD) questionnaire a decade on - A systematic review of the measurement of condition-specific aspects of quality of life in bipolar-disorder. J Affect Disord 2021; 278:33-45. [PMID: 32949871 DOI: 10.1016/j.jad.2020.09.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/28/2020] [Accepted: 09/02/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Condition-specific quality of life (QoL) instruments are more representative of the priorities of people with lived experience. As such, the development of the first and only bipolar disorder (BD) specific measurement instrument, the Quality of Life in Bipolar Disorder (QoL.BD) questionnaire, marked an important step forward for the literature. The present systematic review aims to characterise applications of the QoL.BD in the BD literature and review empirical findings obtained from studies using this measure. METHODS A systematic search identified 37 peer-reviewed publications which reported original empirical data using the QoL.BD in a BD population. No restrictions were placed on language/study type. RESULTS Adaptations to the QoL.BD displayed appropriate psychometric properties. Although clinical trials were typically underpowered, promising effect sizes for a number of treatment modalities were reported. QoL.BD scores were moderately correlated with depressive symptoms; a number of candidate predictors were identified. LIMITATIONS Due to resource limitations, the present review used one database (Google Scholar), and a single author reviewed articles for eligibility. On balance the risks of missing relevant studies were deemed minimal. CONCLUSION A sizeable, international body of evidence now exists regarding the measurement, presentation, and treatment of condition-specific aspects of QoL in BD. Key avenues for future research include large scale, randomized control clinical trials using the QoL.BD as a primary outcome, and granular exploration of potential correlates of QoL.BD domain scores. Finally, longer follow-up periods are required to inform understanding of the dynamic relationship between clinical variables and condition-specific aspects of QoL in BD.
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Morton E, Hou SH, Fogarty O, Murray G, Barnes S, Depp C, Michalak E. A Web-Based Adaptation of the Quality of Life in Bipolar Disorder Questionnaire: Psychometric Evaluation Study. JMIR Ment Health 2020; 7:e17497. [PMID: 32338620 PMCID: PMC7215515 DOI: 10.2196/17497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 02/09/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Quality of life (QoL) is considered a key treatment outcome in bipolar disorder (BD) across research, clinical, and self-management contexts. Web-based assessment of patient-reported outcomes offer numerous pragmatic benefits but require validation to ensure measurement equivalency. A web-based version of the Quality of Life in Bipolar Disorder (QoL.BD) questionnaire was developed (QoL Tool). OBJECTIVE This study aimed to evaluate the psychometric properties of a web-based QoL self-report questionnaire for BD (QoL Tool). Key aims were to (1) characterize the QoL of the sample using the QoL Tool, (2) evaluate the internal consistency of the web-based measure, and (3) determine whether the factor structure of the original version of the QoL.BD instrument was replicated in the web-based instrument. METHODS Community-based participatory research methods were used to inform the development of a web-based adaptation of the QoL.BD instrument. Individuals with BD who registered for an account with the QoL Tool were able to opt in to sharing their data for research purposes. The distribution of scores and internal consistency estimates, as indicated by Cronbach alpha, were inspected. An exploratory factor analysis using maximum likelihood and oblique rotation was conducted. Inspection of the scree plot, eigenvalues, and minimum average partial correlation were used to determine the optimal factor structure to extract. RESULTS A total of 498 people with BD (349/498, 70.1% female; mean age 39.64, SD 12.54 years; 181/498, 36.3% BD type I; 195/498, 39.2% BD type II) consented to sharing their QoL Tool data for the present study. Mean scores across the 14 QoL Tool domains were, in general, significantly lower than that of the original QoL.BD validation sample. Reliability estimates for QoL Tool domains were comparable with that observed for the QoL.BD instrument (Cronbach alpha=.70-.93). Exploratory factor analysis supported the extraction of an 11-factor model, with item loadings consistent with the factor structure suggested by the original study. Findings for the sleep and physical domains differed from the original study, with this analysis suggesting one shared latent construct. CONCLUSIONS The psychometric properties of the web-based QoL Tool are largely concordant with the original pen-and-paper QoL.BD, although some minor differences in the structure of the sleep and physical domains were observed. Despite this small variation from the factor structure identified in the QoL.BD instrument, the latent factor structure of the QoL Tool largely reproduced the original findings and theoretical structure of QoL areas relevant to people with BD. These findings underscore the research and clinical utility of this instrument, but further comparison of the psychometric properties of the QoL Tool relative to the QoL.BD instrument is warranted. Future adaptations of the QoL Tool, including the production of an app-based version of the QoL Tool, are also discussed.
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Affiliation(s)
- Emma Morton
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.,Faculty of Health, Arts and Design, Swinburne University, Hawthorn, Australia
| | | | - Oonagh Fogarty
- Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Greg Murray
- Faculty of Health, Arts and Design, Swinburne University, Hawthorn, Australia
| | - Steven Barnes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Colin Depp
- Department of Psychiatry, University of California, San Diego, CA, United States
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- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Erin Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Pascual-Sánchez A, Jenaro C, Montes-Rodríguez JM. Quality of life in euthymic bipolar patients: A systematic review and meta-analysis. J Affect Disord 2019; 255:105-115. [PMID: 31150940 DOI: 10.1016/j.jad.2019.05.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/17/2019] [Accepted: 05/18/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Patients with bipolar disorder, even euthymic, could suffer an impairment in their quality of life compared to healthy controls. Since no previous systematic review and meta-analysis has been conducted, the aim of the current study is to conduct a systematic review and meta-analysis of cross-sectional case-controlled studies on quality of life in adult euthymic Bipolar Disorder patients. METHODS A systematic review and meta-analysis that followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) was conducted. Major electronic databases were searched on August 2018 to assess the variables associated with quality of life in euthymic bipolar disorder patients. After selecting case-control studies, data collection, quality assessment and subsequently statistical analysis were done. RESULTS 66 studies were finally selected for systematic review and meta-analysis. Four different quality of life instruments were used among the different studies. Effect size analysis showed that there were significant differences in quality of life outcomes between euthymic bipolar disorder patients and healthy controls (d=-0.922; SE=0.316; 95%CI=-1.541--0.303; p=.004), with lower quality of life in the euthymic patients. Furthermore, time since euthymia explained 15.62% of variability, and age of control group explained 29.6% of variability. No other moderators were statiscally significant. LIMITATIONS The instruments used were heterogeneous. Moreover, the role of other clinical moderators could not be included due to the lack of this information in most of the articles. CONCLUSIONS Quality of life is lower in euthymic bipolar patients than in healthy controls. However, longer time in euthymia is associated with better outcomes.
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Affiliation(s)
- Ana Pascual-Sánchez
- Service of Psychiatry, University Hospital Ramón y Cajal, Ctra. Colmenar Viejo km. 9.1, 28034 Madrid, Spain.
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O'Donoghue E, Clark A, Richardson M, Hodsoll J, Nandha S, Morris E, Kane F, O'Keeffe D, Butler L, Jolley S. Balancing ACT: evaluating the effectiveness of psychoeducation and Acceptance and Commitment Therapy (ACT) groups for people with bipolar disorder: study protocol for pilot randomised controlled trial. Trials 2018; 19:436. [PMID: 30103785 PMCID: PMC6090792 DOI: 10.1186/s13063-018-2789-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 07/05/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Bipolar disorder is a chronic and disabling psychiatric condition, characterised by recurrent episodes of mania, hypomania and depression. It places a heavy burden on sufferers and families, with high societal and healthcare costs. Many service users with a diagnosis of bipolar disorder also experience prominent psychotic symptoms, with differential diagnoses of schizoaffective disorder, and relapses characterised by repeated manic psychotic episodes and grandiosity. Such presentations require specific adaptations to standard bipolar disorder interventions in order to address their psychosis, alongside mood regulation, with a particular emphasis on impulsivity, irritability, disinhibition and elation. The Balancing ACT study aims to evaluate an innovative group intervention combining Acceptance and Commitment Therapy and psychoeducation approaches (ACT/PE) with individuals experiencing bipolar disorder and/or symptoms within community psychosis services. METHODS The Balancing ACT study is a randomised controlled trial comparing Balancing ACT groups (ACT/PE) plus routine care to routine care alone. Balancing ACT (ACT/PE) comprises ten group sessions, each lasting 2 hours, delivered weekly. The primary outcome is psychological wellbeing; secondary outcomes are mental health relapses (measured by service use averages for the 12 months pre baseline and 3 months post baseline). We will also measure mood, distress, recovery and psychological change processes. Participants will be randomised in a 1:1 ratio, after baseline assessment. Outcomes will be assessed by trained assessors blind to treatment condition at 0, 10 and 14 weeks. Recruitment began in April 2017 and is on-going until the end of October 2017. DISCUSSION The Balancing ACT study will contribute to the currently limited evidence base for psychological interventions for people experiencing bipolar disorder and/or symptoms in the context of community psychosis services. TRIAL REGISTRATION ISRCTN73327972 . Registered on 27 March 2017. Balancing ACT: evaluating the effectiveness of psychoeducation and Acceptance and Commitment Therapy (ACT) groups for people with bipolar disorder.
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Affiliation(s)
- Emma O'Donoghue
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK. .,South London and Maudsley NHS Foundation Trust, 308-312 Brixton Road, London, SW9 6AA, UK.
| | - Abigail Clark
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | | | - John Hodsoll
- Department of Biostatistics, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8LY, UK
| | - Sunil Nandha
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | | | - Fergus Kane
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
| | - Deirdre O'Keeffe
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - Lucy Butler
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK
| | - Suzanne Jolley
- South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK.,Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, SE5 8AF, UK
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Xiao L, Gao Y, Zhang L, Chen P, Sun X. The relationship between cognitive function and quality of life in euthymic Chinese patients with bipolar disorder. Psychiatry Res 2016; 246:427-431. [PMID: 27788464 DOI: 10.1016/j.psychres.2016.10.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 10/05/2016] [Accepted: 10/17/2016] [Indexed: 01/19/2023]
Abstract
This study aimed to identify the relationship between cognitive function and quality of life (QOL) in Chinese patients with bipolar disorder (BD) in the remission stage, by adopting disease-specific instruments. The remission stage was assessed using the Hamilton Depression Rating Scale (HAMD) and the Bech-Rafaelsen Mania Rating Scale (BRMS). One hundred euthymic bipolar patients and 115 healthy controls completed the "cognitive complaints in bipolar disorder rating assessment"(COBRA), Montreal Cognitive Assessment scale (MoCA), and "Brief version of Quality of Life in Bipolar Disorder" (Bref QOL.BD), which were used to assess the subjective cognitive function, objective cognitive function, and QOL, respectively. Compared to the healthy controls, the patient group had significantly lower total scores on both MoCA and Brief QOL.BD, and higher total score of COBRA. After controlling the influence of mood symptoms (HAMD and BRMS), both objective (MoCA) and subjective (COBRA) cognitive function could predict QOL significantly when entered either separately or simultaneously into hierarchical multiple regression models. When entered simultaneously, cognitive function explained 21% of the variance in QOL. The findings indicated that both objective and subjective cognitive function could influence QOL in euthymic bipolar patients, so continuous cognitive-improving interventions could help euthymic bipolar patients improve their QOL.
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Affiliation(s)
- Lin Xiao
- School of Nursing, Southern Medical University, 1023 Sha Tai South road, Bai Yun district, Guang Zhou, Guangdong province 510515, China.
| | - Yulin Gao
- School of Nursing, Southern Medical University, 1023 Sha Tai South road, Bai Yun district, Guang Zhou, Guangdong province 510515, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, 1023 Sha Tai South road, Bai Yun district, Guang Zhou, Guangdong province 510515, China.
| | - Peiyun Chen
- School of Nursing, Southern Medical University, 1023 Sha Tai South road, Bai Yun district, Guang Zhou, Guangdong province 510515, China
| | - Xiaojia Sun
- School of Nursing, Southern Medical University, 1023 Sha Tai South road, Bai Yun district, Guang Zhou, Guangdong province 510515, China
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Xiao L, Gao Y, Zhang L, Chen P, Sun X, Tang S. Adaptation and validation of the “tolerability and quality of life” (TOOL) questionnaire in Chinese bipolar patients. Qual Life Res 2016; 25:2825-2832. [DOI: 10.1007/s11136-016-1319-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2016] [Indexed: 11/24/2022]
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