title: Patients' perceptions of barriers to self-managing bipolar disorder: A qualitative study.
abstract: BACKGROUND
  Self-management of bipolar disorder (BD) is challenging for many individuals.
  
  
  METHODS
  Interviews were used to assess perceived barriers to disease self-management among 21 high-risk patients with BD. Content analysis, with an emphasis on dominant themes, was used to analyze the data.
  
  
  RESULTS
  Three major domains of barriers emerged: individual barriers (psychological, knowledge, behavioral and physical health); family/community-level barriers (lack of support and resources); and provider/healthcare system (inadequate communication and access to care).
  
  
  CONCLUSIONS
  Care approaches providing social and peer support, optimizing communication with providers and integrating medical and psychiatric care may improve self-management of BD in this vulnerable population.
authors.affiliation: 1 Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA.|2 Center for Health Care Research and Policy, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Blixen
authors.affiliation: 2 Center for Health Care Research and Policy, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Adam T
authors.initials: AT
authors.lastname: Perzynski
authors.affiliation: 1 Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Bukach
authors.affiliation: 3 School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Howland
authors.affiliation: 4 Department of Psychiatry, Neurology, and Biostatistics & Epidemiology, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.|5 Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Sajatovic
keywords: Bipolar disorder; barriers; self-management