Factors influencing alcohol use and treatment adherence in people experiencing bipolar

Towns, Amy and Goodwin, Laura and Klein, Maike (2025) Factors influencing alcohol use and treatment adherence in people experiencing bipolar. PhD thesis, Lancaster University.

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Abstract

Overview: This thesis explores factors influencing adherence to psychological interventions for people living with bipolar. Systematic Review: The systematic review used PRISMA and Synthesis Without Meta-Analysis (SWiM) guidelines to assess quantitative studies that examined factors influencing psychological treatment adherence for people experiencing bipolar. The review found patient-related, treatment-related and disorder-related factors that influence adherence. However, results were inconsistent across studies. The review was further limited by the variability in defining and measuring adherence across studies. Clinical implications and future research directions are discussed. Empirical paper: The empirical paper examined factors influencing alcohol use and treatment adherence to psychological interventions for people living with bipolar. A mixed-methods design was utilised. Results found that education was significantly associated with alcohol use with lower educational attainment more likely to have higher or dependent alcohol use. There were no significant demographic or clinical characteristics found for adherence, however, sample size was limited. Changes in alcohol use were observed post-intervention. Content analysis identified five key themes from service users’ perspectives on adhering to treatment. Limitations in design, the clinical implications of the findings and future research are discussed. Critical appraisal: The critical appraisal provides a summary of the systematic review and empirical paper with an integration of the findings. It discusses the rationale for the chosen topic, provides reflections on the thesis process and highlights key areas for future research.