Role of treatment alliance in the clinical management of bipolar disorder: Stronger alliances prospectively predict fewer manic symptoms

Strauss, Jennifer; Johnson, Sheri L.

doi:10.1016/j.psychres.2006.01.007

Cited by 59 publications

(39 citation statements)

References 55 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A strong therapeutic alliance is central to improve treatment adherence and outcomes 59, 60. Providers should encourage individuals to actively participate in treatment planning, using a shared decision‐making approach 61, 62.…”

Section: Foundations Of Managementmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

View full text Add to dashboard Cite

The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD). These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third‐ line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment‐emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second‐ line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all phases of illness, this hierarchy will further assist clinicians in making evidence‐based treatment decisions. Lithium, quetiapine, divalproex, asenapine, aripiprazole, paliperidone, risperidone, and cariprazine alone or in combination are recommended as first‐line treatments for acute mania. First‐line options for bipolar I depression include quetiapine, lurasidone plus lithium or divalproex, lithium, lamotrigine, lurasidone, or adjunctive lamotrigine. While medications that have been shown to be effective for the acute phase should generally be continued for the maintenance phase in bipolar I disorder, there are some exceptions (such as with antidepressants); and available data suggest that lithium, quetiapine, divalproex, lamotrigine, asenapine, and aripiprazole monotherapy or combination treatments should be considered first‐line for those initiating or switching treatment during the maintenance phase. In addition to addressing issues in bipolar I disorder, these guidelines also provide an overview of, and recommendations for, clinical management of bipolar II disorder, as well as advice on specific populations, such as women at various stages of the reproductive cycle, children and adolescents, and older adults. There are also discussions on the impact of specific psychiatric and medical comorbidities such as substance use, anxiety, and metabolic disorders. Finally, an overview of issues related to safety and monitoring is provided. The CANMAT and ISBD groups hope that these guidelines become a valuable tool for practitioners across the globe.

show abstract

Section: Foundations Of Managementmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Attitudes towards medications among patients might be relatively independent of their demographic and clinical characteristics[50,51,108,109], or they might differ according to age and illness-related factors such as the severity of the illness and its course, comorbid substance use and side effects of medications[85,100,110-113]. Additionally, patients’ attitudes are more likely to be influenced by their knowledge of the illness, attitudes among their family members and ethno-cultural groups, the clinician-patient relationship and the overall quality of life among patients[35,60,84,101,103,114]. However, regardless of the substantial evidence in favour of attitudes and health-beliefs influencing adherence behaviour in BD, the number of studies is relatively small.…”

Section: Patient-centred Determinants Of Non-adherence In Bdmentioning

confidence: 99%

Treatment-adherence in bipolar disorder: A patient-centred approach

Chakrabarti

2016

WJP

View full text Add to dashboard Cite

About half of the patients diagnosed with bipolar disorder (BD) become non-adherent during long-term treatment, a rate largely similar to other chronic illnesses and one that has remained unchanged over the years. Non-adherence in BD is a complex phenomenon determined by a multitude of influences. However, there is considerable uncertainty about the key determinants of non-adherence in BD. Initial research on non-adherence in BD mostly limited itself to examining demographic, clinical and medication-related factors impacting adherence. However, because of inconsistent results and failure of these studies to address the complexities of adherence behaviour, demographic and illness-related factors were alone unable to explain or predict non-adherence in BD. This prompted a shift to a more patient-centred approach of viewing non-adherence. The central element of this approach includes an emphasis on patients’ decisions regarding their own treatment based on their personal beliefs, life circumstances and their perceptions of benefits and disadvantages of treatment. Patients’ decision-making processes are influenced by the nature of their relationship with clinicians and the health-care system and by people in their immediate environment. The primacy of the patient’s perspective on non-adherence is in keeping with the current theoretical models and concordance-based approaches to adherence behaviour in BD. Research over the past two decades has further endorsed the critical role of patients’ attitudes and beliefs regarding medications, the importance of a collaborative treatment-alliance, the influence of the family, and the significance of other patient-related factors such as knowledge, stigma, patient satisfaction and access to treatment in determining non-adherence in BD. Though simply moving from an illness-centred to a patient-centred approach is unlikely to solve the problem of non-adherence in BD, such an approach is more likely to lead to a better understanding of non-adherence and more likely to yield effective solutions to tackle this common and distressing problem afflicting patients with BD.

show abstract

“…Thus, one can relate these results with other studies that raise the importance of social support in BD. Furthermore, these researchers concluded that strong alliances predict a lower frequency of negative attitudes regarding medication, less stigma relating to BD, as well as the possibility of helping to reduce symptoms over time 23 .…”

Section: Discussionmentioning

confidence: 99%

Social support and bipolar disorder

Studart¹,

Filho²,

Studart³

et al. 2015

Arch. Clin. Psychiatry (São Paulo)

View full text Add to dashboard Cite

Background: Bipolar disorder is a chronic condition that affects the functioning of its carriers in many different ways, even when treated properly. Therefore, it's also important to identify the psychosocial aspects that could contribute to an improvement of this population's quality of life. Objective: Carry out a literature review on the role of social support in cases of bipolar disorder. Method: A research on the following online databases PubMed, Lilacs and SciELO was conducted by using the keywords "social support" or "social networks" and "mood disorders" or "bipolar disorder" or "affective disorder, " with no defined timeline. Results: Only 13 studies concerning the topic of social support and BD were found in the search for related articles. Generally speaking, the results show low rates of social support for BD patients. Discussion: Despite the growing interest in the overall functioning of patients with bipolar disorder, studies on social support are still rare. Besides, the existing studies on the subject use different methodologies, making it difficult to establish data comparisons.

show abstract

Role of treatment alliance in the clinical management of bipolar disorder: Stronger alliances prospectively predict fewer manic symptoms

Cited by 59 publications

References 55 publications

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

Treatment-adherence in bipolar disorder: A patient-centred approach

Social support and bipolar disorder

Contact Info

Product

Resources

About