Les attitudes des médecins et des patients en présence de la maladie affective bipolaire : pensons nous d’une manière pareille ?

Aim. The aim of the presented study was an analysis and comparison of patients and psychiatrists beliefs regarding the most important aspects of bipolar disorder (BD) treatment. Method. A group of 100 psychiatrists (with at least 5 years professional experience) and a group of 100 remitted patients fulfilling ICD-10 and DSM IV-TR BD criteria (aged 18–65) were enrolled. Their beliefs were investigated with a 41-item structuralized questionnaire (doctors group) and 27-item self evaluation inventory (patients group). The construction of both tools made it possible to compare the results and was based on hierarchical ranking of answers included in each item. Results. A number of important concordances were indicated between doctors and patients beliefs e.g. both groups considered that: 1) the depression is the most burdensome episode in the course of BD; 2) the pharmacotherapy is the most crucial element of treatment; 3) the improvement of life quality is the most important aspect of recovery. On the other hand the results revealed that patients are convinced that doctors consider improving their life quality as much less important than alleviating symptoms severity. The hierarchy of problems proposed by the patients as the main obstacles in taking drugs appeared to be the exact antithesis of doctors beliefs in this issue. The patients indicated drug side effects as the main cause whereas doctors considered compliance as a crucial problem. Discrepancies in beliefs were also observed regarding the perceived importance of different psychoeducation topics: coping abilities and life quality improvement – two most important issues in patients opinion, were placed on the remote rank in doctors hierarchy, giving place to early recognition of relapse symptoms and suicidality prevention. Conclusion. Discrepancies of psychiatrists and patients beliefs regarding crucial aspects of BD treatment that were revealed in the study may be responsible for worsening of compliance quality