A nationwide study on concordance with multimodal treatment guidelines in bipolar disorder

Joannes W. Renes, Eline J. Regeer, Adriaan W. Hoogendoorn, Willem A. Nolen, Ralph W. Kupka

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Background: Most previous studies on concordance with treatment guidelines for bipolar disorder focused on pharmacotherapy. Few studies have included other treatment modalities. Aims: To study concordance with the Dutch guideline of various treatment modalities in outpatient treatment settings for patients with bipolar disorder and to identity factors associated with concordance. Methods: A nationwide non-interventional study using psychiatrists’ and patients’ surveys. Results: 839 patients with bipolar or schizoaffective disorder bipolar type were included. Concordance with the guideline was highest for participation of a psychiatrist in the treatment (98%) and for maintenance pharmacotherapy (96%), but lower for supportive treatment (73.5%), use of an emergency plan (70.6%), psychotherapy (52.2%), group psychoeducation (47.2%), and mood monitoring (47%). Presence of a written treatment plan, a more specialized treatment setting, more years of education, and diagnosis of bipolar I disorder versus bipolar II, bipolar NOS, or schizoaffective disorder were significantly associated with better concordance. Conclusion: In contrast to pharmacotherapy, psychosocial treatments are only implemented to a limited extend in everyday clinical practice in bipolar disorder. More effort is needed to implement non-pharmacological guideline recommendations for bipolar disorder.

Original languageEnglish
Article number22
JournalInternational Journal of Bipolar Disorders
Issue number1
Publication statusPublished - 1 Dec 2018


  • Bipolar
  • Concordance
  • Guidelines

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