Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology

Journal of Psychopharmacology - Tập 30 Số 6 - Trang 495-553 - 2016
GM Goodwin1, Peter Haddad2, I. Nicol Ferrier3, J K Aronson4, Thomas Re Barnes5, Andrea Cipriani1, David Coghill6, Seena Fazel1, John Geddes1, Heinz Grunze7, Emily A. Holmes8, Oliver Howes9, Stephen M. Hudson10, Neil Hunt11, Ian Jones12, Ian C. MacMillan13, R. Hamish McAllister‐Williams3, DavidJ. Miklowitz14, Richard Morriss15, Marcus R. Munafò16, Carol Paton17, Barbara J. Sahakian18, Kate Saunders1, Julia Sinclair19, David Taylor20, Eduard Vieta21, Allan H. Young22
1University Department of Psychiatry, Warneford Hospital, Oxford, UK
2Greater Manchester West Mental Health NHS Foundation Trust, Eccles, Manchester, UK
3Institute of Neuroscience, Newcastle University, UK and Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
4Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK
5The Centre for Mental Health, Imperial College London, Du Cane Road, London, UK
6MACHS 2, Ninewells’ Hospital and Medical School, Dundee, UK; now Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, VIC, Australia
7Univ. Klinik f. Psychiatrie u. Psychotherapie, Christian Doppler Klinik, Universitätsklinik der Paracelsus Medizinischen Privatuniversität (PMU), Salzburg, Christian Doppler Klinik Salzburg, Austria
8MRC Cognition & Brain Sciences Unit, Cambridge, UK
9Institute of Psychiatry (Box 67), London, UK
10Bipolar UK, London, UK
11Fulbourn Hospital, Cambridge, UK
12MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, UK
13Northumberland, Tyne and Wear NHS Foundation Trust, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK
14UCLA Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
15Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
16MRC Integrative Epidemiology Unit, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
17Oxleas NHS Foundation Trust, Dartford, UK
18Department of Psychiatry (Box 189), University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK
19University Department of Psychiatry, Southampton, UK
20South London and Maudsley NHS Foundation Trust, Pharmacy Department, Maudsley Hospital, London, UK
21Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
22Centre for Affective Disorders, King’s College London, London, UK

Tóm tắt

The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.

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