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Intervention trials for adults with bipolar disorder in low-income and lower-middle-income countries: A systematic review.
- Source :
-
Journal of affective disorders [J Affect Disord] 2022 Aug 15; Vol. 311, pp. 256-266. Date of Electronic Publication: 2022 May 20. - Publication Year :
- 2022
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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.<br />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.<br />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.<br />Limitations: Heterogeneity across studies prevented any meaningful pooling of data to meta-analyses.<br />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.<br />Trial Registration: PROSPERO: CRD42020170953.<br /> (Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1573-2517
- Volume :
- 311
- Database :
- MEDLINE
- Journal :
- Journal of affective disorders
- Publication Type :
- Academic Journal
- Accession number :
- 35605708
- Full Text :
- https://doi.org/10.1016/j.jad.2022.05.097