Bipolar
About this PSP
This PSP identified unanswered questions about bipolar at a time when new technologies and approaches to understanding bipolar (including brain imaging and online mood management systems) were becoming available. These advances expand the scope of research making it more important than ever that future research priorities are set by people with personal or professional experience of bipolar.
The PSP was funded by the Leeds and York Partnership NHS Foundation Trust, the NIHR Oxford Biomedical Research Centre, MQ, Oxford Health NHS Foundation Trust, and the University of Oxford Department of Psychiatry. It was also supported by a wide range of organisations including Bipolar UK, SANE, Service User Research Enterprise, British Association for Counselling and Psychotherapy, Royal College of Nursing, Cochrane Collaboration Common Mental Disorders Group, and the British Association for Psychopharmacology. The Bipolar PSP was co-ordinated by the NIHR Oxford Biomedical Research Centre.
3,283 people responded to the original survey, submitting a total of 14,492 questions. 71 unanswered questions were included in the interim survey. Over 2,200 people responded to the interim survey, ranking the questions in terms of importance.
The Bipolar Top 10 was published in August 2016.
Top 10 priorities
- What causes bipolar?
- How can treatments be tailored to individuals?
- What is the most effective combination of self-management approaches, therapy and medication?
- What are the best ways to manage suicide risk among people with bipolar?
- What could be done for people who do not get better with treatment?
- What are the best ways to manage the side-effects of medication (including weight gain, problems with thinking and memory, and emotional numbness)?
- Why does it take so long to get a diagnosis of bipolar disorder, and how could time to diagnosis be shortened?
- Which are the best medications for treating episodes and for prevention of relapse in bipolar?
- How effective are talking therapies such as counselling, dynamic psychotherapy and CBT?
- Can medications with fewer side-effects be developed?
The following questions were also discussed and put in order of priority at the workshop:
- Can bipolar be managed effectively without medication and if so how, and what are the long term outcomes?
- Can bipolar be prevented, and if so, how?
- What is the best and most cost effective way to provide clinical care for those with bipolar, including who should provide it?
- What can we learn about managing bipolar from the people who are managing the condition well?
- What are the most effective ways for people with bipolar to monitor their condition, and take steps to avoid or minimise the impact of a relapse?
- How can the time it takes to get a diagnosis of bipolar be shortened?
- How effective are combinations of medication, e.g. antidepressant plus a mood-stabilising drug, in the treatment of bipolar?
- What are the risks and benefits to mother and baby of medication for bipolar (e.g. during pregnancy, childbirth and breastfeeding)?
- What are the unwanted long-term effects of medication?
- How can family members and carers best be supported to manage life with a person with bipolar?
- What are the outcomes of people with bipolar being more involved in decisions about their treatment?
- What are the most effective ways to train and support a person with bipolar so they are motivated and able to manage the condition themselves?
- What are the triggers for bipolar episodes (e.g. life events and stress) and how do these vary?
- Can bipolar be prevented in people who are at high risk because they have a family history of bipolar?
- What is the impact of more positive attitudes to bipolar amongst (a) health professionals and (b) people affected by bipolar?
- Can bipolar be prevented in later life with children/teenagers/ young adults who already have mild symptoms (depression, anxiety and mood swings)?
- What impact does bipolar have, including on education, work, relationships, parenting and quality of life?
- What precise lifestyle changes can individuals make to manage their bipolar (e.g. diet, exercise, sleep, yoga, meditation, rest, routine, sunlight, change of job, avoiding alcohol and recreational drugs)?
- Can medication such as antidepressants trigger the onset of bipolar or worsen its course?
- How can family members and carers best support people with bipolar (e.g. through education, training and practical support)?
- Is it possible to fully recover from bipolar and live a ‘normal’ life, or are people always affected throughout their lives?
- How effective are the forms of support for people with bipolar (professional, social, family, peer support)?
- How often should medication plans be reviewed, and should dosage change?
- What are the best ways to support parents with bipolar?
- How are children of parents with bipolar affected by their parent(s)’ illness, including can they learn bipolar behaviours?