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      Acceptance, coping strategies and health behaviors in bipolar disorder patients taking and not taking lithium carbonate

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          Abstract

          BACKGROUND

          The variety of dysfunctions in bipolar disorder (BD) affects patients’ perceptions of the diagnosis, acceptance, and illness. Treatment of people with BD includes pharmacotherapy and psychotherapy. Maintaining long-term therapy is difficult, related to the patients’ overall approach to health. The aim was to assess health attitudes in people with BD treated with different mood stabilizers.

          PARTICIPANTS AND PROCEDURE

          The study group included 40 patients diagnosed with bipolar disorder. Participants were divided into two groups depending on the medication taken: a group taking lithium ( n = 20) and a group not taking lithium, treated with other drugs ( n = 20). The respondents were measured with psychological tests – Addenbrooke’s Cognitive Examination, Illness Acceptance Scale, Health Behavior Inventory, and Coping Inventory in Crisis Situations.

          RESULTS

          85% of the respondents stopped taking medication at least once without the doctor’s knowledge. People taking lithium had a significantly lower acceptance of the disease ( t = –2.27, p = .015). The study groups did not differ in terms of coping with stress and health behaviors. The correlation analysis indicated that the acceptance of disease and health behaviors are significantly associated with selected coping strategies.

          CONCLUSIONS

          Attitudes towards health, understood as acceptance of the disease, coping with stress, and health behaviors are average. It is advisable to develop an optimal approach to activities connected with the daily health maintenance of the patients in order to better cope with the disease and its symptoms.

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          Most cited references33

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          Understanding the impact of stigma on people with mental illness.

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            Nonconscious processes and health.

            Health behavior theories focus on the role of conscious, reflective factors (e.g., behavioral intentions, risk perceptions) in predicting and changing behavior. Dual-process models, on the other hand, propose that health actions are guided not only by a conscious, reflective, rule-based system but also by a nonconscious, impulsive, associative system. This article argues that research on health decisions, actions, and outcomes will be enriched by greater consideration of nonconscious processes. A narrative review is presented that delineates research on implicit cognition, implicit affect, and implicit motivation. In each case, we describe the key ideas, how they have been taken up in health psychology, and the possibilities for behavior change interventions, before outlining directions that might profitably be taken in future research. Correlational research on implicit cognitive and affective processes (attentional bias and implicit attitudes) has recently been supplemented by intervention studies using implementation intentions and practice-based training that show promising effects. Studies of implicit motivation (health goal priming) have also observed encouraging findings. There is considerable scope for further investigations of implicit affect control, unconscious thought, and the automatization of striving for health goals. Research on nonconscious processes holds significant potential that can and should be developed by health psychologists. Consideration of impulsive as well as reflective processes will engender new targets for intervention and should ultimately enhance the effectiveness of behavior change efforts. PsycINFO Database Record (c) 2013 APA, all rights reserved.
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              Relapse and impairment in bipolar disorder.

              The purpose of this study was to evaluate the outcome of bipolar disorder in the context of maintenance pharmacotherapy. Eighty-two bipolar outpatients were followed prospectively for a mean of 4.3 years (minimum of 2 years); symptom rating and psychosocial outcome scales were used, and pharmacotherapy was rated on a 5-point scale. Despite continual maintenance treatment, survival analysis indicated a 5-year risk of relapse into mania or depression of 73%. Of those who relapsed, two-thirds had multiple relapses. Relapse could not be attributed to inadequate medication. Even for those who did not relapse, considerable affective morbidity was observed. A measure of cumulative affective morbidity appeared to be a more sensitive correlate of psychosocial functioning than was the number of relapses. Poor psychosocial outcome paralleled poor syndromal course. Poor psychosocial functioning, especially occupational disruption, predicted a shorter time to relapse. Depressions were most strongly related to social and family dysfunction. Even aggressive pharmacological maintenance treatment does not prevent relatively poor outcome in a significant number of bipolar patients.
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                Author and article information

                Contributors
                Role: Study design, Data collection, Statistical analysis, Data interpretation, Manuscript preparation, Literature search
                Role: Data collection
                Role: Study design, Manuscript preparation, Literature search
                Journal
                Health Psychol Rep
                Health Psychol Rep
                HPR
                Health Psychology Report
                Termedia Publishing House
                2353-4184
                2353-5571
                18 January 2022
                2022
                : 10
                : 3
                : 168-176
                Affiliations
                [1]Poznan University of Medical Sciences, Poznan, Poland
                Author notes
                CORRESPONDING AUTHOR – Karolina Kabzińska-Milewska, Department of Clinical Psychology, Poznan University of Medical Sciences, 70 Bukowska Str., 60-812 Poznan, Poland, e-mail: kabzinska.ump@ 123456gmail.com
                Author information
                https://orcid.org/0000-0001-5515-8954
                https://orcid.org/0000-0002-6311-6778
                https://orcid.org/0000-0002-6345-1795
                Article
                144984
                10.5114/hpr.2021.112090
                10679922
                38084274
                6d44765e-0b97-49c3-8e01-f00fbb650acc
                Copyright © Institute of Psychology, University of Gdansk

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License ( http://creativecommons.org/licenses/by-nc-sa/4.0/)

                History
                : 23 June 2021
                : 31 July 2021
                : 16 December 2021
                Categories
                Original Article

                bipolar disorder,lithium carbonate,acceptance,coping strategy,health behaviors

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