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Patients’ Perspectives on Residual Symptoms in Bipolar Disorder: A Focus Group Study

Samalin, Ludovic MD*; Bellivier, Frank MD, PhD†‡§; Giordana, Bruno MD; Yon, Liova MD; Milhiet, Vanessa MD; El-Hage, Wissam MD, PhD; Courtet, Philippe MD, PhD#; Hacques, Evguenia MD**; Bedira, Nabil MD††; Dillenschneider, Anne MD††; Llorca, Pierre Michel MD, PhD

The Journal of Nervous and Mental Disease: July 2014 - Volume 202 - Issue 7 - p 550–555
doi: 10.1097/NMD.0000000000000157
Original Articles

Euthymic bipolar patients are often impacted by residual symptoms (RSs) that increase the risk of relapse or low functioning. We aimed to identify the perceptions of RSs, barriers to management, and service needs in euthymic bipolar patients. A qualitative methodology (focus group) was used. The interviews were investigated using a semistructured guide, tape-recorded, transcribed verbatim, and analyzed thematically. Twenty-three bipolar patients expressed concern about several RSs, such as emotional dysregulation, circadian rhythm disruption, cognitive impairment, low self-esteem, and physical symptoms. They reported concern about the impact of RSs on their functioning and about the need for more systematic assessment of RSs during interepisode visits. Selection bias may have occurred because the recruitment was limited to France and there may be cultural differences in the perceptions of RSs. Bipolar patients experienced bipolar disorder as a chronic disorder because they frequently continued to suffer from RSs associated with a functional impact.

*CHU Clermont-Ferrand, Auvergne University, Clermont-Ferrand; †CHU Saint-Louis–Lariboisière, Paris; ‡INSERM U955, Créteil; §Fondation FondaMental, Créteil; ∥CHU Pasteur, Nice; ¶CRHU Tours, INSERM U930, François Rabelais University, Tours; #CHRU Montpellier, INSERM U1061, Montpellier University, Montpellier; **Otsuka Pharmaceuticals France SAS, Rueil Malmaison; and ††Bristol-Myers Squibb, Rueil Malmaison, France.

This work was supported by grants from Bristol-Myers Squibb France, but it had no special role in the study design or in the collection, analysis, and interpretation of the data.

Send reprint requests to Ludovic Samalin, MD, Adult Psychiatry B, CHU Clermont-Ferrand, Auvergne University, 58 rue Montalembert, 63000 Clermont-Ferrand, France. E-mail: lsamalin@chu-clermontferrand.fr.

© 2014 by Lippincott Williams & Wilkins