Brief report Clinical impact of late diagnose of bipolar disorder Fernando Kratz Gazalle a,b , Ana Cristina Andreazza a,b , Keila Maria Cerese ´r a,b , Pedro Curi Hallal c , Aida Santin a,b , Fla ´vio Kapczinski a,b, T a Psychiatry Research Unit, Post-Graduate Psychiatry Program, Federal University of Rio Grande Do Sul, Brazil b Bipolar Disorders Program, University Hospital, Federal University of Rio Grande Do Sul, Brazil c Post-Graduate Program in Epidemiology, Federal University of Pelotas, Brazil Received 29 November 2004; accepted 12 January 2005 Abstract Background: This study assessed the impact of number of years undiagnosed (NYU) on current morbidity in patients with bipolar disorder. Limitations: The sample size used was rather small, which may make difficult the generalization of our findings to larger datasets. The data about age of onset and age when patients received their diagnosis may present a certain degree of recall error. Method: Sixty-five bipolar outpatients diagnosed using the Structured Clinical Interview for DSM were included. The main outcome measurements were quality of life (QOL) assessed using the 26-item World Health Organization QOL instrument (WHOQOL-Bref) and depression assessed using the 17-item Hamilton Depression Rating Scale (HDRS). Results: Age of onset and years of disorder were not correlated with the outcomes assessed. The NYU were associated with higher scores of HDRS ( Pb0.01), lower scores of QOL within the physical ( p b0.01) and psychological ( p b0.05) domains of QOL. Conclusion: Our findings suggest that the NYU may be an important predictor of the current clinical status of bipolar patients. D 2005 Elsevier B.V. All rights reserved. Keywords: Bipolar disorder; Quality of life; Depression; Diagnosis 1. Introduction Bipolar disorder (BD) is a chronic and often life- threatening condition with a lifetime prevalence of 1.2% (Weissman et al., 1996). The World Health Organization estimates that bipolar disorder is the fifth leading cause of disability among young adults (Murray and Lopez, 1997). About 15% of patients with BD commit suicide (Goodwin and Jamison, 1990), and mortality in general is increased among bipolar patients (Bauer et al., 2001). There is an emerging body of evidence showing the association of BD with low scores of quality of life (QOL). Quality of life seems to be impaired during mood 0165-0327/$ - see front matter D 2005 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2005.01.003 T Corresponding author. Laborato ´rio de Psiquiatria Experimental, Centro de Pesquisas, Hospital de Clı ´nicas de Porto Alegre, Ramiro Barcelos 2350, zip code: 90035-000, Porto Alegre, RS, Brazil. Tel.: +55 51 32227309; fax: +55 51 32228047. E-mail address: kapcz@terra.com.br (F. Kapczinski). Journal of Affective Disorders 86 (2005) 313 – 316 www.elsevier.com/locate/jad