Table 1.

Unmet Needs in the Treatment of BD Patients Identified in the Literature

Diagnosis char="12"

• Early correct diagnosis

• Recognition and treatment of somatic health problems

Efficacy and effectiveness of therapeutic options

• Only 2–3 agents are efficacious across all phases

• The definition of ‘mood stabilizer’ is problematic

• Combining treatments is usually necessary to achieve an acceptable level of efficacy

• Research so far neglects outcomes like disability, quality of life, burden, and economic issues

• Limited data on treatments for acute bipolar depression

• Lack of access to specialized care services

Gender

• Little research on gender issues

• There are some data suggesting that gender is related to different clinical pictures, adverse events profile and to different outcomes

• Issues related to female physiology and reproduction, especially pregnancy and breast feeding

Unmet needs: the therapists’ point of view

• Education and support for patients and families

• Earlier referral to specialist care

• Improved effectiveness and patient adherence

• A minority of therapists adheres to evidence-based standards

• There is an unmet need for the continuous education of professionals

Unmet needs: the patients’ and caregivers’ point of view

• Clinical research never focuses on the unmet needs as the patients conceive them

• The generalizability of research data to the real-world patient is unknown

• Burden of caregivers of patients

Adherence to treatment

• Psychoeducation is not routinely applied at the earlier stages

• Empowerment of service users is not the standard