Understanding Treatment Adherence Among Individuals With Rapid Cycling Bipolar Disorder

Bipolar Disorder (BPD), also known as manic-depressive illness, is a disorder that causes
frequent shifts in an individual's mood, energy, and ability to function. An individual with
BPD may go through periods of mania, which are characterized by increased energy,
irritability, and an excessively "high" euphoric mood. The manic periods are followed by
periods of depression, which are characterized by decreased energy, feelings of hopelessness,
and anxiety. Rapid cycling bipolar disorder (RCBPD) is a type of BPD in which the individual
experiences four or more episodes of mania and depression per year. The rapid shift between
the manic and depressive episodes makes it imperative that individuals with RCBPD strictly
manage their illness with medication. Many BPD medications have been developed recently;
however, there are still many individuals who do not respond well to medication treatment.
Research has shown that the way individuals experience illness has an effect on their
response to medication. The purpose of this study is to gain insight into how individuals
with RCBPD perceive and respond to medication treatment. Factors such as gender, degree of
social support, drug and alcohol usage, and attitudes towards medication will be evaluated to
understand how they affect medication and treatment adherence.

This study will consist of 1 visit, which will last approximately 2 and ½ hours and will
include an anthropological interview and numerous standardized psychological questionnaires.
The interview and questionnaires will assess participants' attitudes toward BPD treatment;
psychiatric illness severity, including symptoms of mania and depression; expectations
regarding recovery, stigma, and quality of life; and medication adherence.

Inclusion Criteria:

- Clinical diagnosis of rapid cycling variant of bipolar disorder type I; diagnosed 2 to
20 years prior to study entry

- Has experienced an index depressive episode

- Received treatment with medication to stabilize mood for at least 6 months prior to
study entry

- Lives in the Northeast Ohio area and is a patient at either Northeast Ohio Health
Services or The Mood Disorders Clinic at University Hospitals of Cleveland

Exclusion Criteria:

- Unable/unwilling to participate in psychiatric interviews