Attitudes towards pharmacotherapy in late-life bipolar disorder
Open accessAbstract
BACKGROUND: Lithium remains a first-line treatment for bipolar disorder, but clinicians have considerable concern over potential adverse effects, especially in older adults. Older patients' attitude towards lithium has not been investigated, even though negative attitudes are closely associated with reduced adherence. We examine the attitude towards lithium pharmacotherapy in older adults with bipolar disorder. METHODS: In a cross-sectional study of 78 patients aged >60 years with bipolar disorder, the association between lithium use and attitudes towards psychotropic pharmacotherapy was assessed using the Drug Attitude Inventory (DAI-10), including multivariate analyses. RESULTS: Compared to patients using alternative psychopharmacological treatments (n =30), lithium users (n=48) showed higher self-reported contentedness, subjective somatic health, and social functioning scores. Although 58.7% of lithium users reported severe adverse effects, lithium users had more positive attitudes towards psychotropic pharmacotherapy compared to non-users (DAI-10 mean score 6.0 vs. 3.9, p =0.01), and this effect was independent of potential confounders. CONCLUSIONS: Older bipolar patients using lithium have a more positive attitude towards psychotropic pharmacotherapy, despite high rates of adverse effects. Future longitudinal studies could investigate whether positive medication attitudes lead to improved treatment adherence and reduced bipolar disorder relapse in older lithium users.
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In a longitudinal study, greater reductions in the use of antipsychotic drugs over time were found in facilities with a resident-centred culture, a less severe case mix and a higher nurse-to-resident staffing ratio.
“In a longitudinal study, greater reductions in the use of antipsychotic drugs over time were found in facilities with a resident-centred culture, a less severe case mix and a higher nurse-to-resident staffing ratio [76].”
From Stakeholders' views on the use of psychotropic medication in older people: a systematic review (2022) · cites this paper as [76]
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“In a longitudinal study, greater reductions in the use of antipsychotic drugs over time were found in facilities with a resident-centred culture, a less severe case mix and a higher nurse-to-resident staffing ratio [76].”
Background
- Authors
- Rej, S., Schuurmans, J., Elie, D., Stek, M. L., Shulman, K., & Dols, A.
- Affiliations
- University of Toronto (CA)
- GGZ inGeest (NL)
- Corresponding author
- Rej, Soham
- Venue
- International Psychogeriatrics
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 28
- Issue
- 6
- Pages
- 945-950
- ISSN
- 1041-6102 (ISSN-L)
- OpenAlex
- W2344333340
- Cited by
- 23
- References
- 35
- Citations by year
- 2026: 4 · 2025: 1 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 1 · 2017: 2
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Psychogeriatrics (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Canadian Institutes of Health Research
- Santé
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- bipolar disorder, late-life bipolar disorder, lithium, older adults, Drug Attitude Inventory, adverse drug reactions, medication adherence, psychotropic drugs, subjective well-being, social functioning
- MeSH terms
- Aged, Bipolar Disorder, Cross-Sectional Studies, Female, Humans, Health Knowledge, Attitudes, Practice, Lithium, Longitudinal Studies, Male, Middle Aged, Netherlands, Patient Compliance, Psychotropic Drugs, Quality of Life, Surveys and Questionnaires, Urban Population
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