한국형 양극성 장애 약물치료 알고리듬의 적용 가능성(IV) : 삶의 질

Abstract

The Korean College of Neuropsychopharmacology and the Korean Academy of Schizophrenia developed the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) as a reference for clinical decisions. The purpose of this study was to investigate the effects of pharmacological treatments with the KMAPBP on quality of life in patients with bipolar disorder. Methods：Brief Form of World Health Organization Quality of Life assessment (WHOQOL-BREF), at baseline and 4 months after treatment, was used to evaluate the quality of life in this study. Also Young Mania Rating Scale (YMRS), Hamilton Rating Scale for Depression (HAM-D), Global Assessment of Functioning (GAF), and two scales of Clinical Global Impression (CGI-S, CGI-I) were rated by clinicians. Data from 76 of 92 bipolar patients, treated according to the algorithm, were attained at baseline, 55 at 4 months after treatment, and 47 at both. Results：It was found that the treatments following the KMAPBP for 4 months could not make improvement in all 4 domains of WHOQOL-BREF. There was no difference in change of QOL domains after treatment according to some variables such as sex, age, age of onset, age of first treatment, clinical feature of mania, and so on. Compared with mania, in which quality of life was aggravated a little after treatment, all domains of WHOQOL-BREF were improved in bipolar depressed patients. The improvement of YMRS score had a negative correlation with physical health domain. The decrease in HAM-D score was correlated positively with improvement in physical health and psychological domains. But there was no correlation between increase in quality of life and the improvement of GAF, CGI-S, and CGI-I scores. Conclusion：Quality of life was not improved in bipolar patients at 4 months after treatment, in which the KMAP-BP was applied. But it did not mean that the application of the algorithm to treat bipolar patients was not effective. Because their functions were not recovered yet, even though the symptoms were remitted. Long-term follow-up studies using various tools to estimate the quality of life are needed.