title: Caregiver burden in bipolar hypomania and mania: a systematic review.
abstract: OBJECTIVE
  Bipolar mania is characterized by marked impairment in social, occupational, or other important areas of functioning. One should expect to see an equally severe burden in informal caregivers. The literature was reviewed in order to provide a foundation upon which to build nursing interventions.
  
  
  CONCLUSIONS
  Several characteristics of bipolar mania-patient aggressiveness, lack of insight, and financial problems-were identified as severe burdens to caregivers. Professionals might not have a total view of the extent of the burden in caregivers. This review could not link the patients' mania or hypomania to factors that were described in other literature on caregiver burden related to bipolar disorder, regardless of the type of episode.
  
  
  CONCLUSIONS
  There is a need for further research in this area to make more explicit the burden on caregivers during times of mania or hypomania.
authors.affiliation: University of Utrecht, Utrecht, the Netherlands and Clinical Nurse Specialist, Dimence Mental Health Care Centre, Deventer, The Netherlands. gpearson@uchc.edu
authors.forename: Titus A A
authors.initials: TA
authors.lastname: Beentjes
authors.forename: Peter J J
authors.initials: PJ
authors.lastname: Goossens
authors.forename: Irina E
authors.initials: IE
authors.lastname: Poslawsky
mesh_terms: D000223:Adaptation, Psychological; D001714:Bipolar Disorder / Q000451:nursing*; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005190:Family / Q000523:psychology; D006801:Humans; D018454:Spouses / Q000523:psychology