The Bipolar Comprehensive Outcomes Study (BCOS) is an ongoing, Australian, 2-year, observational study of participants with bipolar I or schizoaffective disorder, designed to examine the economic, clinical and functional outcomes associated with treatment in a ‘real-life’ context.
Participants prescribed olanzapine or conventional mood stabilizers were assessed at entry using the Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAMD21), Clinical Global Impressions Scale – Bipolar Version (CGI-BP) and the EuroQol Instrument.
On average, participants were 41.8 ± 12.7 years of age. About 58% (n = 140) were women, and 73% (n = 176) had a diagnosis of bipolar I disorder. Olanzapine was prescribed to 35% (n = 85) of participants, and more commonly for schizoaffective disorder (48% vs. 31% for bipolar). Based on CGI-BP scores, more women were markedly ill (34% vs. 22%, women vs. men) and significantly more depressed than men [HAMD21 total score 14.3 ± 8.7 vs. 12.1 ± 8.3, P = 0 .048; CGI-BP depression scores 3.5 ± 1.3 vs. 2.8 ± 1.3, P < 0 .001 (women vs. men)]. Participants were on average, hypomanic, with YMRS total and CGI-BP mania scores of 8.2 ± 8.5 and 3.0 ± 1.6, respectively. Bipolar participants rated their overall health state significantly higher than those with schizoaffective disorder. This trend was also reflected by the mean weekly wage ($500-$999, 21.3% vs. 6.3%, per cent participants, bipolar vs. schizoaffec-tive), unemployment rate (22.2% vs. 48.4%) and relationship status (47.1% vs. 26.6%, P = 0 .005).
Participants were characterized by social and occupational dysfunction at study entry, but those with schizoaffective disorder appeared to be more severely affected. Effective treatment is required to address both clinical and functional impairment.