TY - JOUR
T1 - Intervention trials for adults with bipolar disorder in low-income and lower-middle-income countries
T2 - A systematic review
AU - Arnbjerg, C. J.
AU - Rurangwa, N. U.
AU - Musoni-Rwililiza, E.
AU - Gishoma, D.
AU - Carlsson, J.
AU - Kallestrup, P.
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022
Y1 - 2022
N2 - 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.
AB - 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.
KW - Bipolar disorder
KW - Global mental health
KW - Intervention trials
KW - Low-income countries
KW - Low-resource setting
KW - Lower-middle-income countries
U2 - 10.1016/j.jad.2022.05.097
DO - 10.1016/j.jad.2022.05.097
M3 - Journal article
C2 - 35605708
AN - SCOPUS:85130509780
VL - 311
SP - 256
EP - 266
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -