Quality of life and its correlates in patients with dual diagnosis of bipolar affective disorder and substance dependence

Objectives: To compare the quality of life (QOL) of patients having dual diagnosis of bipolar affective disorder and substance dependence with those having either diagnosis alone and with healthy controls. Methods: Cross-sectional assessment of the four groups of subjects was made. Euthymic bipolar patients and those substance dependent patients not in active withdrawal or intoxication were included. QOL assessment was made with the World Health Organization (WHO)-QOL - Bref Hindi version. Results: Total QOL score and scores on all the four domains of WHO-QOL-Bref were significantly lower for the dual-diagnosis (DD) patients when compared with all the other groups. Significant negative correlations were found between (i) the number of days the drug was consumed and the score on the 'general well-being' items of WHO-QOL-Bref (r = -0.31, p < 0.05); and (ii) between severity of alcohol dependence and WHO-QOL total score (r = -0.44, p < 0.01) as well as its 'psychological' domain (r = -0.52, p < 0.05). Conclusions: The study indicates that bipolar DD patients experience a lower QOL when compared with the other groups studied. Their QOL is affected by the severity of alcohol dependence.