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DOI: 10.1055/s-2007-993213
© 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 DisorderPublication History
received 08.06.2007
revised 08.09.2007
accepted 05.10.2007
Publication Date:
18 January 2008 (online)
![](https://www.thieme-connect.de/media/pharmaco/200801/lookinside/thumbnails/10.1055-s-2007-993213-1.jpg)
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