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Developing a Rat Model for Bipolar Disorder
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Advance Decision Making in Bipolar: A Systematic Review.
Lucy A Stephenson1, Tania Gergel1, Astrid Gieselmann2
1Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Frontiers in Psychiatry
|November 16, 2020
Summary
People with bipolar disorder are interested in advance decision making (ADM) for treatment, preferring supported and collaborative planning. Further research is needed to optimize ADM for fluctuating capacity.
Area of Science:
- Psychiatry
- Mental Health Law
Background:
- Advance decision making (ADM) allows individuals to plan for future treatment decisions when capacity may be lost.
- ADM is particularly relevant for Bipolar Affective Disorder (bipolar) due to fluctuating decision-making capacity.
- Empirical evidence on ADM in bipolar disorder is limited, necessitating a systematic review.
Approach:
- A PRISMA-compliant systematic review of empirical literature was conducted.
- The review synthesized findings from 11 studies, including mixed-methods, quantitative descriptive, and one randomized controlled trial.
- Outcomes focused on interest in ADM, preferred types, barriers, and impact.
Key Points:
- Individuals with bipolar disorder express interest in engaging with ADM.
- Preferred ADM approaches are supported, collaborative, and allow for stating treatment preferences (requests and refusals).
- People with bipolar disorder may encounter fewer barriers to ADM compared to other severe mental illnesses.
Conclusions:
- Limited evidence highlights the value of clinician support in creating ADM documents for individuals with bipolar disorder.
- Upcoming legal reforms in England and Wales will increase the focus and demand for ADM.
- Further research is crucial to clarify ADM assumptions, valued outcomes, barriers, and to develop tailored ADM models for fluctuating capacity.
Keywords:
advance care planningadvance statementhuman rightsmental capacitymental healthmental health lawpsychiatric advance directivesMore Related Videos
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