Identifying and improving non-adherence in bipolar disorders

Authors

  • F Colom,

    1. Bipolar Disorders Program, Institut d'Investigacions Biomédiques Agustí Pi Sunyer, Barcelona Stanley Foundation Center Barcelona
    2. Division of Psychological Medicine, Institute of Psychiatry, London
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  • E Vieta,

    1. Bipolar Disorders Program, Institut d'Investigacions Biomédiques Agustí Pi Sunyer, Barcelona Stanley Foundation Center Barcelona
    2. Department of Psychiatry, Hospital Clinic, University of Barcelona, Barcelona, Spain
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  • MJ Tacchi,

    1. NNNT Mental Health Trust, Newcastle upon Tyne, UK
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  • J Sánchez-Moreno,

    1. Bipolar Disorders Program, Institut d'Investigacions Biomédiques Agustí Pi Sunyer, Barcelona Stanley Foundation Center Barcelona
    2. Psychiatry Department, Universidad Autonoma de Madrid, Madrid, Spain
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  • J Scott

    1. NNNT Mental Health Trust, Newcastle upon Tyne, UK
    2. Division of Psychological Medicine, Institute of Psychiatry, London
    3. University of Newcastle upon Tyne, Royal Victoria Infirmary, Newcastle upon Tyne, UK
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Dr. Jan Scott, Division of Psychological Medicine, Institute of Psychiatry, P.O. Box 96, Denmark Hill, London 8E5 8AF, UK. Fax: 44 207 8482015; e-mail: j.scott@iop.kcl.ac.uk

Abstract

Objectives:  To review the definition of non-adherence, its clinical and economic impact and identify its role and impact in clinical practice.

Methods:  A selective review of the literature as conducted of articles and literature known to the authors.

Results:  There is a paucity of studies examining specifically treatment non-adherence and its consequences in bipolar disorder. Few studies have systematically examined ways in which treatment adherence can impact treatment and improve outcome.

Conclusion:  Non-adherence is common in the management of bipolar disorder. Clinicians and Researchers alike need to remain alert and be aware of issues related to non-adherence – in particular suicide. Like other course-modifiers non-adherence has to be considered, sought and addressed, and this is perhaps best done by including psychoeducation in routine clinical care.

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