title: Guidelines concordance of maintenance treatment in euthymic patients with bipolar disorder: Data from the national bipolar mania pathway survey (BIPAS) in mainland China.
abstract: BACKGROUND
  Although the treatment guidelines of bipolar disorders (BPD) have spread more than a decade, the concordance with evidence-based guidelines was typically low in routine clinical practice. This study is to present the data on the maintenance treatment of BPD in mainland China.
  
  
  METHODS
  One thousand and twenty-three patients who had experienced a euthymia were eligible for entry into this survey on the maintenance treatment of BPD. Guidelines disconcordance was determined by comparing the medication(s) that patients were prescribed with the recommendations in the guidelines of the Canadian Network for Mood and Anxiety Treatments.
  
  
  RESULTS
  Three hundred and sixty-four patients (35.6%) had not been prescribed with the maintenance treatment as guidelines recommendations, and 208 patients (20.3%) were prescribed with the antidepressants. A longer duration of BPD, a depressive episode at first onset, and a recent depressive or mixed episode significantly increased the risk for guidelines disconcordance and prescribing antidepressant. In contrast, a hospitalization history due to manic episode was associated with a significant decrease in the risk for guidelines disconcordance and prescribing antidepressant.
  
  
  CONCLUSIONS
  This study was a cross-sectional and retrospective investigation based on medical records.
  
  
  CONCLUSIONS
  Considering the potentially hazardous effects of inappropriate treatment, individualized psychoeducational strategies for subjects with BPD are necessary to enhance treatment adherence and close the gap between guidelines and clinical practice in mainland China.
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China; Division of Mood Disorders, Hongkou District Mental Health Center of Shanghai, Shanghai 200083, PR China. Electronic address: wzwhk@163.com.
authors.forename: Zuowei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Mood and Anxiety Clinic in the Mood Disorders Program, Department of Psychiatry, University Hospitals Case Medical Center/Case Western Reserve University School of Medicine, Cleveland, OH 44106, United States.
authors.forename: Keming
authors.initials: K
authors.lastname: Gao
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Wu
authors.initials: W
authors.lastname: Hong
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Mengjuan
authors.initials: M
authors.lastname: Xing
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Zhiguo
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Chengmei
authors.initials: C
authors.lastname: Yuan
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Jia
authors.initials: J
authors.lastname: Huang
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Daihui
authors.initials: D
authors.lastname: Peng
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Lu
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China.
authors.forename: Zhenghui
authors.initials: Z
authors.lastname: Yi
authors.affiliation: Institute of Mental Health, Peking University, Beijing 100191, PR China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yu
authors.affiliation: Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, PR China.
authors.forename: Jingping
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, PR China. Electronic address: yirufang@aliyun.com.
authors.forename: Yiru
authors.initials: Y
authors.lastname: Fang
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressants; Bipolar disorder; Euthymia; Guidelines; Maintenance treatment