Self‐reported care needs of outpatients with a bipolar disorder in the Netherlands

Goossens, Peter; Klein, E.A.M. Knoppert-van der; Kroon, Hans; Achterberg, Theo van

doi:10.1111/j.1365-2850.2007.01127.x

Cited by 25 publications

(24 citation statements)

References 18 publications

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“…The proportion of met vs unmet needs and the types of unmet needs in this study were very similar to several Indian studies, which have assessed health-care needs among patients with severe mental illnesses including schizophrenia and BD[18,22,25,29-31]. The pattern of primacy of economic and welfare needs in Indian studies is also quite unlike the pattern of needs reported in Western studies, where a greater amount of help and benefits are usually received from health-care services; therefore, social needs are more often unmet than economic, welfare or treatment needs[7,24,32-35]. These differences clearly reflect the inadequate support that patients receive from formal health-care services in India, which forces them to turn to their family and friends to fulfil their needs[18,22,26].…”

Section: Discussionmentioning

confidence: 99%

Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia

Neogi¹,

Chakrabarti²,

Grover³

2016

WJP

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AIMTo investigate health-care needs and their correlates among patients with remitted bipolar disorder (BD) compared to patients with remitted schizophrenia.METHODSOutpatients with BD (n = 150) and schizophrenia (n = 75) meeting clearly defined remission criteria were included in the study along with their relatives. Diagnostic ascertainment was carried out using the Mini International Neuropsychiatric Interview. Demographic and clinical details were recorded using structured formats. Residual symptoms were assessed using standardized scales. Health-care needs were assessed on two separate scales. The principal instrument employed to assess health-care needs was the Camberwell Assessment of Need-Research version (CAN-R). To further evaluate health-care needs we felt that an additional instrument, which was more relevant for Indian patients and treatment-settings and designed to cover those areas of needs not specifically covered by the CAN-R was required. This instrument with a structure and scoring pattern similar to the CAN-R was used for additional evaluation of needs. Patients’ level of functioning was assessed using the Global Assessment of Functioning Scale and their quality of life (QOL) using the World Health Organization Quality Of Life-BREF version in Hindi.RESULTSAn average of 6-7 needs was reported by patients with BD as well as their relatives. Commonly reported needs were in the areas of economic and welfare needs, informational needs, social needs and the need for treatment. According to the CAN-R, both patients and relatives reported that more than 60% of the total needs were being met. However, over 90% of the needs covered by the additional evaluation were unmet according to patients and relatives. Needs in the areas of economic and welfare-benefits, information, company, daytime activities and physical health-care were largely unmet according to patients and relatives. Total, met and unmet needs were significantly higher for schizophrenia, but the most common types of needs were quite similar to BD. Relatives reported more needs than patients with certain differences in the types of needs reported. Level of patients’ functioning was the principal correlate of greater total and unmet needs in both groups. Significant associations were also obtained with residual symptoms and QOL.CONCLUSIONThe presence of unmet needs in remitted patients with BD was an additional marker of the enduring psychosocial impairment characteristic of the remitted phase of BD.

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Section: Discussionmentioning

confidence: 99%

Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia

Neogi¹,

Chakrabarti²,

Grover³

2016

WJP

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“…Another research field focuses on care needs of outpatients with BD (Goossens, Knoppert-Van der Klein, Kroon & Van Achterberg, 2007), showing that the needs were mainly to be found in the areas of psychological help, psychiatric help and social functioning. The data in the study by Goossens et al (2007) was collected by using a survey technique with fixed questions.…”

Section: Introductionmentioning

confidence: 99%

“…The data in the study by Goossens et al (2007) was collected by using a survey technique with fixed questions. Existential issues were not in focus.…”

Section: Introductionmentioning

confidence: 99%

Extra dimensions in all aspects of life—the meaning of life with bipolar disorder

Rusner

Carlsson

Brunt

et al. 2009

International Journal of Qualitative Studies on Health and Well

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Living with Bipolar Disorder (BD) greatly affects the whole life; still the meaning of it is poorly explored from the perspective of the individuals actually living with it. The aim of this study is thus to explore the existential meaning of life with BD. Ten persons, six women and four men, (aged 30–61), diagnosed with BD were interviewed. A reflective lifeworld perspective based on phenomenological philosophy was used. The findings show that living with BD entails experiencing extra dimensions in all aspects of life, expressed in terms of a magnitude and complexity beyond that which is perceived as pertaining to normal life. The essential meaning of the phenomenon is further described by its constituents: “a specific intensity”, “a struggle to understand”, “an illness that is intertwined with one's whole being”. Living with BD means more for the individual than having episodes of depression and mania and must therefore be understood from a holistic perspective. Adequate care for persons with BD, therefore, includes places for safe and profound reflecting about existential issues, such as identity, trust and self-confidence. The present study recommends the caring services to change their ways to explain and talk about the BD illness.

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“…Lack of access to such services probably adversely influences the overall long-term outcome (Morgan et al, 2005; Goossens et al, 2007). …”

Section: Unmet Needs Identified In the Literature (Summarized In Tmentioning

confidence: 99%

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research

Fountoulakis

Vieta

Young

et al. 2016

IJNPPY

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Background:The current fourth paper on the International College of Neuropsychopharmacology guidelines for the treatment of bipolar disorder reports on the unmet needs that became apparent after an extensive review of the literature and also serves as a conclusion to the project of the International College of Neuropsychopharmacology workgroup.Materials and Methods:The systematic review of the literature that was performed to develop the International College of Neuropsychopharmacology guidelines for bipolar disorder identified and classified a number of potential shortcomings.Results:Problems identified concerned the reliability and validity of the diagnosis of bipolar disorder and especially of bipolar depression. This, in turn, has profound consequences for early detection and correct treatment of the disorder. Another area that needs improvement is the unsatisfactory efficacy and effectiveness of therapeutic options, especially in special populations such as those with mixed features and rapid cycling course. Gender issues and adherence problems constitute an additional challenge. The literature suggests that while treatment providers are concerned more with treatment-related issues, patients and their caregivers worry more about issues pertaining to the availability of services and care, quality of life, and various types of burden. The workgroup identified additional unmet needs related to the current standard of research in bipolar disorder. These include the fragmentation of bipolar disorder into phases that are handled as being almost absolutely independent from each other, and thus the development of an overall therapeutic strategy on the basis of the existing evidence is very difficult. Trials are not always designed in a way that outcomes cover the most important aspects of bipolar disorder, and often the reporting of the results is biased and unsatisfactory. The data on combination treatments and high dosages are sparse, whereas they are common in real world practice.Conclusions:The workgroup endorses the full release of raw study data to the scientific community, and the development of uniform clinical trial standards (also including more realistic outcomes) and the reporting of results. The 2 large appendices summarize the results of this systematic review with regard to the areas of lack of knowledge where further focused research is necessary.

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Self‐reported care needs of outpatients with a bipolar disorder in the Netherlands

Cited by 25 publications

References 18 publications

Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia

Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia

Extra dimensions in all aspects of life—the meaning of life with bipolar disorder

The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research

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