OBJECTIVES: To derive a patient-based model of quality of life (QoL) for bipolar disorder (BPD).
METHODS: Qualitative research methods were employed to investigate the impact of BPD on QoL. Specifically, to identify how patients perceive their condition to affect their life quality and how they define “QoL”. Semi-structured interviews were conducted with women with a clinical diagnosis of BPD. Interpretive phenomenological analysis (IPA) was used to explore and interpret participants’ perceptions of QoL impact. IPA involves two stages: a case-by-case thematic analysis, and an interpretive analysis to connect and cluster themes. For the latter, emphasis was placed on interpreting the meaning and importance ascribed by patients to the impact of BPD. The data were then compared to existing models of QoL to derive a QoL model for BPD.
RESULTS: As IPA requires small sample sizes, interviews were conducted with four women (26–92 (mean 49.5) years). Psychometric tests were employed to ensure that the women were not currently depressed (BDI) or manic (SCAN, MRS). Analysis revealed that BPD has a profound impact on affected individuals. Thematic analysis identified key areas of impact including; social life, personal relationships, self-esteem, work life, fear of rejection and impact on day-to-day activities. Interpretive analysis revealed eight key thematic clusters including; intimate personal relationships, social impact and personal development/fulfillment. Relating these to existing models of QoL suggested that a needs-based model of QoL impact was the most appropriate for BPD. The model suggested that areas of need adversely affected by BPD related to; safety and security, belongingness and love needs; esteem; cognitive needs and self-fulfillment.
CONCLUSION: BPD impacts many life areas. Application of IPA revealed that the needs-based model of QoL can successfully be used to explain the patient’s perception of, and response to, the symptomatic and functional impact of the condition.
