Autistic-like traits and longitudinal changes in health-related quality of life among individuals with bipolar disorder: A 12-month study.
OBJECTIVE: Autistic-like traits are common in bipolar disorder (BD) and have been linked to poor functional outcomes, yet their longitudinal impact on quality of life (QOL) remains unclear. This study examined whether autistic-like traits are associated with 12-month changes in health-related QOL in BD. METHODS: Seventy-eight outpatients with BD who completed 12-month follow-up assessments were included (mean age = 34.9 years). Autistic-like traits were assessed using the Social Responsiveness Scale for Adults (SRS-A), with participants classified into elevated- and non-elevated-traits groups. Depressive and manic symptoms were evaluated using the 17-item Hamilton Depression Rating Scale (HAMD-17) and the Young Mania Rating Scale (YMRS). QOL was measured using the 36-Item Short-Form Health Survey (SF-36). Linear mixed models were used to examine longitudinal changes. RESULTS: HAMD-17 scores demonstrated significant main effects of time and group, reflecting overall improvement but persistently higher depressive symptoms in the elevated-traits group. YMRS scores indicated a significant group effect only. Physical QOL remained stable, while mental QOL improved over time without group differences. Role/social QOL showed significant main effects of time and group, with consistently lower scores in the elevated-traits group. No group × time interactions emerged, suggesting similar rates of change between groups. CONCLUSIONS: This prospective study suggests that autistic-like traits in BD are associated with persistently poorer role/social functioning over time rather than differences in recovery trajectories. Assessing autistic-like traits may help identify patients at risk of poorer functioning and guide tailored psychosocial interventions.