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In some studies of bipolar disorder, use of treatment guidelines improved outcomes. To learn more about strategies for long-term concordance with guidelines, researchers analyzed data on antimanic treatment from a Veterans Affairs multisite treatment study of bipolar disorder, in which 306 veterans hospitalized for bipolar I or II disorder were randomized at discharge to 3 years of collaborative care or usual care.
The only medical or psychiatric exclusions were dementia or terminal illness with a life expectancy under 3 years. Patients had had a mean of 5.3 hospitalizations in the previous 5 years; 87% had bipolar I disorder, 65% had a history of suicide attempts, and 34% had psychosis at hospitalization. Substance use disorders were curren…