Illness Representations in Patients With Bipolar Disorders

Study Overview
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Brief Summary
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Bipolar disorder is a serious and chronic illness representing a major health problem with high mortality rates. According to the self-regulation model , patients had some representations of their illness which are cognitive and emotional. Cognitive representations include the set of beliefs built around the illness, its consequences and treatment. Emotional representations are negative emotions generated by the presence of the illness. According to Leventhal et al. (1997), representations are linked to information extracts by patients from society, relatives, experiences. This model has been particularly studied in the context of somatic disorders, but Baines & Wittkowski (2013) shown that it may also be relevant in patients with mental disorders. In bipolar disorders, first results show that illness representations are related to relapses and to medication adherence. That's why, we think that this relevant to improve knowledges of the psychological processes that accompany the experience of bipolar disorders. To assess illness representation, we will use both qualitative and quantitative tools. These results could have direct application to clinical practice in psychosocial interventions.

Detailed Description
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Bipolar disorder is a serious and chronic illness representing a major health problem with high mortality rates (Colom and Lam, 2005). According to the self-regulation model (Leventhal, Nerenz & Steel, 1986), patients had some representations of their illness which are cognitive and emotional. Cognitive representations include the set of beliefs built around the illness, its consequences and treatment. Emotional representations are negative emotions generated by the presence of the illness. According to Leventhal et al. (1997), representations are linked to information extracts by patients from society, relatives, experiences. This model has been particularly studied in the context of somatic disorders, but Baines & Wittkowski (2013) shown that it may also be relevant in patients with mental disorders. In bipolar disorders, first results show that illness representations are related to relapses (Lobban et al., 2013) and to medication adherence (Averous, Charbonnier, Lagouanelle-Simeoni, Prosperi & Dany, 2018). That's why, we think that this relevant to improve knowledges of the psychological processes that accompany the experience of bipolar disorders. To assess illness representation, we will use both qualitative and quantitative tools. These results could have direct application to clinical practice in psychosocial interventions.

Official Title
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Illness Representations in Patients With Bipolar Disorders. What Mecanisms and What Impacts on Adherence and Quality of Life ?

Conditions
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Bipolar Disorder

Intervention / Treatment
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* Other: standardized questionnaires
* Other: interview


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men or women whose is between 18 and 85 years Patients diagnosed bipolar in mania, depression or euthymic phases according DSM-IV critiera by psychiatrist Taking in charge in the framework of service Psychiatrie Secteur 5 - Hôpitaux Sud - Hôpital Sainte Marguerite de Marseille Patients agreeing to participate to study Exclusion Criteria: Minor patients or over 85 years old Patients not understanding French Patients with neurological or psychiatric disorders prohibiting their comprehension of the study Patients deprived of their liberty following a judicial or administrative decision Patients supported without their consent Patients under legal guardianship Patients treated in emergencies Patients refusing to participate in the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| experimental group<br>• Patients diagnosed bipolar in mania, depression or euthymic phases according DSM-IV critiera by psychiatrist standardized questionnaires and interview will be performed | Other: standardized questionnaires<br>* standardized questionnaires concerning the perception<br>Other: interview<br>* Semi-directive interviews will be conducted. The purpose of this approach is to question the meaning of the disease (beliefs, representations), the psycho-social management of the disease, its inscription in the socio-cultural condition of the patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Illness perception for schizophrenia (IPQS) | IPQS in an autoquestionnaire evaluating illness representations according to the self-regulation model. | 24 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Illness Perception Questionnaire Bref (IPQ-B) | IPQ-B evaluate similar dimensions from IPQ-S in only once item. | 24 hours | 
| Qualitative study of illness perceptions | Measure of illness representations according to the self-regulation model evaluated with a semi-structured interview. | 24 hours |