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Pharmacopsychiatry 2008; 41(1): 29-36
DOI: 10.1055/s-2007-993213
Original Paper

© Georg Thieme Verlag KG Stuttgart · New York

Determinants of Voluntary vs. Involuntary Admission in Bipolar Disorder and the Impact of Adherence

Results from the EMBLEM Study on Acute Mania of Bipolar Disorder D. Schuepbach 1 , D. Novick 2 , J. M. Haro 3 , C. Reed 2 , H. Boeker 1 , S. Noda 1 , J. Angst 1 , D. Hell 1 ,  the EMBLEM Advisory Board 1
  • 1Psychiatric University Hospital Zurich, Zurich, Switzerland
  • 2Eli Lilly and Company, Lilly Research Center, Windlesham, United Kingdom
  • 3Sant Joan de Déu-SSM, Sant Boi de Llobregat, Barcelona, Spain
Further Information

Publication History

received 08.06.2007 revised 08.09.2007

accepted 05.10.2007

Publication Date:
18 January 2008 (online)

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Abstract

Introduction: Treatment adherence plays a pivotal role in hospitalisation in bipolar disorder (BD). We examined the impact of adherence and pharmacological variables on involuntary vs. voluntary admission on a sample of inpatients from the European Mania in Bipolar Longitudinal Evaluation of Medication study (EMBLEM).

Methods: 1374 inpatients with an acute manic or mixed episode of BD participated in this observational study on clinical, functional and economic outcomes of pharmacological treatment. We analysed data at the time of study inclusion, and the primary outcome measure was admission status (voluntary vs. involuntary admission).

Results: The strongest baseline factor of admission status was adherence whereby patients’ adherence was significantly associated with admission when treated with atypical antipsychotics or lithium as monotherapy. Adherence with typical antipsychotics was not significantly associated with admission status.

Discussion: These results emphasise the crucial role of treatment adherence for admission status and, within the context of a naturalistic study, some advantage of atypical over typical antipsychotics on admission in acute mania of BD.

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Correspondence

D. SchuepbachMD 

Psychiatric University Hospital Zurich

P.O. Box 1931

8032 Zurich

Switzerland

Phone: +41/44/384 21 11

Fax: +41/44/383 44 56

Email: daniel.schuepbach@puk.zh.ch

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