Trajectory and predictors of quality of life in first episode psychotic mania

Meredith Oldis, Greg Murray, Craig A. Macneil, Melissa K. Hasty, Rothanthi Daglas, Michael Berk, Philippe Conus, Sue M. Cotton

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7 Citations (Scopus)


Background Little is known about the trajectory of quality of life (QoL) following a first episode of psychotic mania in bipolar disorder (BD). This 18-month longitudinal study investigated the trajectory of QoL, and the influence of premorbid adjustment and symptoms on 18-month QoL in a cohort of young people experiencing a first episode of psychotic mania. Methods As part of an overarching clinical trial, at baseline, sixty participants presenting with a first episode of psychotic mania (BD Type 1 - DSM-IV) completed symptomatic and functional assessments in addition to the Premorbid Adjustment Scale - General Subscale. Symptom measures were repeated at 18-month follow up. QoL was rated using the Quality of Life Scale (QLS) at designated time points. Results Mean QLS scores at initial measurement (8 weeks) were 61% of the maximum possible score, increasing significantly to 70% at 12 months, and 71.2% at 18-month follow-up. Premorbid adjustment and 18-month depressive symptoms were significantly associated with QoL at 18-month follow-up. Limitations Study limitations include the small sample size, inclusion of participants with psychotic mania only, use of measures originally designed for use with schizophrenia spectrum disorders, and lack of premorbid or baseline measurement of QoL. Conclusions Results suggest that QoL can be maintained early in BD, and reinforce the importance of assertively treating depressive symptoms throughout the course of this disorder. The emergence of a link between premorbid adjustment and poorer QoL in this cohort highlights the importance of assessing facets of adjustment when planning psychological interventions.

Original languageEnglish
Pages (from-to)148-155
Number of pages8
JournalJournal of Affective Disorders
Publication statusPublished - May 2016
Externally publishedYes


  • Bipolar disorder
  • First episode
  • Mania
  • Psychosis
  • Quality of Life

Cite this

Oldis, M., Murray, G., Macneil, C. A., Hasty, M. K., Daglas, R., Berk, M., Conus, P., & Cotton, S. M. (2016). Trajectory and predictors of quality of life in first episode psychotic mania. Journal of Affective Disorders, 195, 148-155.