Mismatch between self-reported quality of life and functional assessment in acute mania: A matter of unawareness of illness?

Fernando Kratz Gazalle, Benício Noronha Frey, Pedro Curi Hallal, Ana Cristina Andreazza, Ângelo Batista M. Cunha, Aida Santin, Flávio Kapczinski

Research output: Contribution to journalArticlepeer-review


Background: Studies addressing self-reported quality of life (QoL) in acute mania are scarce and inconsistent. While it has been suggested that there is some disagreement between objective measures and subjective QoL as reported by acutely manic patients, this issue has not been systematically studied. This study aims to investigate the self-reported QoL in manic, depressed, and euthymic BD subjects, as compared to matched healthy controls. Methods: One-hundred and twenty type-I bipolar patients (40 manic, 40 depressed, and 40 euthymic) and 40 matched controls were studied. Self-reported QoL was assessed using the World Health Organization's Quality of Life Instrument-Short Version (WHOQOL-BREF). Objective functioning was assessed using the Global Assessment of Functioning (GAF), and depressive and manic symptoms were assessed using the Hamilton Depression Rating Scale-17 items (HDRS) and the Young Mania Rating Scale (YMRS), respectively. Results: Manic patients presented the lowest GAF measures but reported same overall QoL as euthymic patients and controls, and better QoL than depressed patients. Within the manic subgroup, there was a significant inverse correlation between psychological QoL and GAF scores (r = - 0.54; p = 0.001). Limitations: The cross-sectional design and the lack of control for potential comorbid conditions are the major limitations of the present study. Conclusions: Our findings suggest that this mismatch between objective and subjective measures during acute mania may be associated with a lack of insight or awareness of their own illness.

Original languageEnglish (US)
Pages (from-to)247-252
Number of pages6
JournalJournal of Affective Disorders
Issue number1-3
StatePublished - Nov 2007
Externally publishedYes


  • Anosognosia
  • Bipolar disorder
  • Insight
  • Mania
  • Psychosis
  • Quality of life

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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