Intervention trials for adults with bipolar disorder in low-income and lower-middle-income countries: A systematic review.
J Affect Disord
; 311: 256-266, 2022 08 15.
Article
em En
| MEDLINE
| ID: mdl-35605708
ABSTRACT
BACKGROUND:
The treatment gap for bipolar disorder is aggravated by economic inequality. Around half of the world's population live in a low-or lower-middle-income country, where research on treatment is scarce. Hence, this review aims to determine the number and types of intervention studies conducted on adults with bipolar disorder in low-income and lower-middle-income countries and analyze the effect of these interventions on symptom severity, medical adherence, and quality of life.METHODS:
A systematic review was conducted in June and November 2021 using eight databases. Controlled intervention trials on adults with bipolar disorder on data from low-income and lower-middle-income countries at time of publication were included. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials or The Risk Of Bias In Non-randomized Studies of Interventions assessment tool.RESULTS:
Twenty-one studies met the inclusion criteria. These were divided into four subtypes based on the intervention; pharmacotherapy (=12), psychosocial (=7), electroconvulsive therapy (=1), and traditional medicine (=1). Three studies were from low-income countries. A high risk of bias characterized the studies; only four studies reported the procedures used for randomization. Most studies, however, identified a beneficial effect on symptom severity, and in addition, medical adherence could be improved with psychosocial interventions.LIMITATIONS:
Heterogeneity across studies prevented any meaningful pooling of data to meta-analyses.CONCLUSION:
Data for treatment interventions contextualized to the local setting for bipolar disorder remains sparse, particularly from low-resource settings. Further studies are urgently needed to target the treatment gap for bipolar disorder. TRIAL REGISTRATION PROSPERO CRD42020170953.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transtorno Bipolar
/
Países em Desenvolvimento
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article