The challenges of living with bipolar disorder: a qualitative study of the implications for health care and research

Abstract

BackgroundIn mental health care, clinical practice is often based on the best available research evidence. However, research findings are difficult to apply to clinical practice, resulting in an implementation gap. To bridge the gap between research and clinical practice, patients’ perspectives should be used in health care and research. This study aimed to understand the challenges people with bipolar disorder (BD) experience and examine what these challenges imply for health care and research needs.MethodsTwo qualitative studies were used, one to formulate research needs and another to formulate healthcare needs. In both studies focus group discussions were conducted with patients to explore their challenges in living with BD and associated needs, focusing on the themes diagnosis, treatment and recovery.ResultsPatients’ needs are clustered in ‘disorder-specific’ and ‘generic’ needs. Specific needs concern preventing late or incorrect diagnosis, support in search for individualized treatment and supporting clinical, functional, social and personal recovery. Generic needs concern health professionals, communication and the healthcare system.ConclusionPatients with BD address disorder-specific and generic healthcare and research needs. This indicates that disorder-specific treatment guidelines address only in part the needs of patients in everyday clinical practice.

Employability of Persons With Mental Disability: Understanding Lived Experiences in Kenya

“…The discrimination and stigma associated with mental illness often affect the decision to disclose, which makes it impossible to obtain reasonable accommodation in education and employment. The dilemma of disclosure and identifying as an individual with mental or psychosocial disability also limits employment opportunities (11–13). In high-income countries, supported employment practices for vocational rehabilitation of individuals with mental disabilities are associated with improved employment outcomes (14–17).…”

The influence of stage of illness on functional outcomes after psychological treatment in bipolar disorder: A systematic review

“…Fewer intervention studies appear to prioritize functional outcomes in BD. Given that these are meaningful for those with BD 92,93 and may emerge as especially important in later illness stages, 17,22 more emphasis on functional outcomes is encouraged.…”

Have I argued with my family this week?”: What questions do those with lived experience choose to monitor their bipolar disorder?

“…In BD there has been increasing recognition of the value of gaining insights from the patient perspective both clinically and in research. To date studies have used patientcentred approaches to examine the challenges of both living with and managing BD (Jönsson et al, 2008;Maassen et al, 2018;Nestsiarovich et al, 2017) as well as to further define patient-important outcomes, including quality of life (Eiring et al, 2016;Michalak et al, 2006;Morton et al, 2018). However, the scope for electronic mood monitoring to capture the patient priorities for longitudinal BD monitoring from their own perspective has not been previously explored.…”