Determinants of voluntary vs. involuntary admission in bipolar disorder and the impact of adherence

Pharmacopsychiatry
D SchuepbachEMBLEM Advisory Board

Abstract

Treatment adherence plays a pivotal role in hospitalisation in bipolar disorder (BD). We examined the impact of adherence and pharmacological variables on involuntary vs. voluntary admission on a sample of inpatients from the European Mania in Bipolar Longitudinal Evaluation of Medication study (EMBLEM). 1374 inpatients with an acute manic or mixed episode of BD participated in this observational study on clinical, functional and economic outcomes of pharmacological treatment. We analysed data at the time of study inclusion, and the primary outcome measure was admission status (voluntary vs. involuntary admission). The strongest baseline factor of admission status was adherence whereby patients' adherence was significantly associated with admission when treated with atypical antipsychotics or lithium as monotherapy. Adherence with typical antipsychotics was not significantly associated with admission status. These results emphasise the crucial role of treatment adherence for admission status and, within the context of a naturalistic study, some advantage of atypical over typical antipsychotics on admission in acute mania of BD.

Citations

Apr 27, 2012·European Psychiatry : the Journal of the Association of European Psychiatrists·E VietaF Kapczinski
May 8, 2014·The International Journal of Neuropsychopharmacology·Bianca PfaffensellerFlávio Kapczinski
Sep 6, 2008·The International Journal of Neuropsychopharmacology·Marcia Kauer-Sant'AnnaLakshmi N Yatham
Aug 24, 2016·International Journal of Psychiatry in Clinical Practice·Andrea AgugliaGiuseppe Maina
Jun 15, 2017·Revista brasileira de psiquiatria : orgão oficial da Associação Brasileira de Psiquiatria, Asociación Psiquiátrica de la América Latina·Andrea AgugliaGiuseppe Maina
Nov 17, 2017·Chronobiology International·Andrea AgugliaGiuseppe Maina
May 2, 2018·International Journal of Bipolar Disorders·Maximilian PilhatschMichael Bauer
Sep 5, 2019·International Journal of Bipolar Disorders·M BauerP C Whybrow
Sep 11, 2019·Journal of Affective Disorders·Adam FijtmanMárcia Kauer-Sant'Anna

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