title: Communication and decision-making in mental health: A systematic review focusing on Bipolar disorder.
abstract: To systematically review studies of communication and decision-making in mental health-based samples including BP patients.
  
  
  
  Qualitative systematic review of studies using PsychINFO, MEDLINE, SCOPUS, CINAHL, and EMBASE (January 2000-March 2015). One author assessed study eligibility, verified by two co-authors. Data were independently extracted by two authors, and cross-checked by another co-author. Two independent raters assessed eligible studies using a validated quality appraisal.
  
  
  
  Of 519 articles retrieved, 13 studies were included (i.e., 10 quantitative/1 qualitative/1 mixed-methods). All were cross-sectional; twelve were rated good/strong quality (>70%). Four inter-related themes emerged: patient characteristics and patient preferences, quality of patient-clinician interactions, and influence of SDM/patient-centred approach on patient outcomes. Overall BP patients, like others, have unmet decision-making needs, and desire greater involvement. Clinician consultation behaviour influenced patient involvement; interpersonal aspects (e.g., empathy, listening well) fostered therapeutic relationships and positive patient outcomes, including: improved treatment adherence, patient satisfaction with care, and reduced suicidal ideation.
  
  
  
  This review reveals a paucity of studies reporting bipolar-specific findings. To inform targeted BP interventions, greater elucidation of unmet decision-making needs is needed.
  
  
  
  Eliciting patient preferences and developing a collaborative therapeutic alliance may be particularly important in BP, promoting improved patient outcomes.
authors.affiliation: School of Psychology, University of Sydney, NSW 2006, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, NSW 2006, Australia.
authors.forename: Alana
authors.initials: A
authors.lastname: Fisher
authors.affiliation: School of Psychiatry, University of New South Wales, NSW 2031, Australia; Black Dog Institute, University of New South Wales, NSW, 2031, Australia.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Manicavasagar
authors.affiliation: School of Psychology, University of Sydney, NSW 2006, Australia.
authors.forename: Felicity
authors.initials: F
authors.lastname: Kiln
authors.affiliation: School of Psychology, University of Sydney, NSW 2006, Australia; Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), University of Sydney, NSW 2006, Australia. Electronic address: ilona.juraskova@sydney.edu.au.
authors.forename: Ilona
authors.initials: I
authors.lastname: Juraskova
mesh_terms: D001714:Bipolar Disorder / Q000523:psychology*; D003142:Communication; D003657:Decision Making; D003661:Decision Support Techniques; D006801:Humans; D008603:Mental Health; D010358:Patient Participation; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care
keywords: Bipolar disorder; Communication; Decision-making; Patient involvement; Patient outcomes; Treatment